Complications & Cesareans – Managing Group B Strep
Dawn Fox of Mount Juliet, Tenn., had a 3-month-old daughter when she became pregnant again at the age of 26. Her second pregnancy, like her first, was uneventful and without complication. When she went into labor, during her 39th week, all of that changed.
Fox was running a high fever and her baby began to show signs of distress. An emergency C-section was performed and soon after the delivery, it became clear that her baby girl, Ellison, was sick. She was immediately transported to the neonatal intensive care unit (NICU) of a nearby hospital where tests revealed that she was infected with the Group B streptococcus bacteria and suffering from sepsis (a blood infection) and pneumonia. “We were told that our daughter was ‘in grave condition,'” says Fox. “That phrase haunts me to this day.”
What Is GBS?
According to the Centers for Disease Control and Prevention (CDC), Group B streptococcus (GBS) is a type of bacteria that can cause illness in newborn babies, pregnant women, the elderly and adults with other illnesses, such as diabetes or liver disease. Many adults carry GBS in their bodies without ever becoming ill, but pregnant women who carry GBS in their rectum or vagina (one out of every four or five are carriers, according to CDC estimates) run the risk of exposing their babies to the bacteria during labor and delivery.
GBS is the most common cause of life-threatening infections in newborns.
GBS is the most common cause of life-threatening infections in newborns, including sepsis and meningitis, as well as the frequent cause of newborn pneumonia. In pregnant women, GBS can cause bladder infections, womb infections, and stillbirth. CDC figures suggest that one out of every 20 babies with GBS disease will die from the infection and those that survive may experience a host of long-term problems.
After Ellison’s birth, Fox was horrified to learn that simple screening and prevention measures existed that could have prevented her daughter’s severe illness. “I knew nothing about GBS at the time,” she says. “My doctor never said a word to me because I wasn’t considered high-risk. My daughter endured weeks of intrusive treatment while we waited and wondered if we were going to lose her. She is now a healthy and happy 5-year-old, and for that we are grateful, but it has taken me a very long time to come to terms with what happened and to get over the anger associated with the experience.”
What Can You Do About It?
In 1996, the same year that Fox gave birth to Ellison, the CDC issued guidelines for GBS prevention and screening. According to Dr. Traci Kurtzer, an obstetrician-gynecologist with ENH Medical Group in Deerfield, Ill., the CDC guidelines recommend two strategies for preventing GBS. “The first way is for practitioners to give every pregnant woman a genital and rectal culture at 35 to 37 weeks gestation and to administer prophylactic antibiotic therapy based on the results,” says Dr. Kurtzer.” The second way is to base prophylactic antibiotic treatment on risk factors alone. These factors include a history of previous infant GBS infection, a history of GBS related urinary tract infection, premature labor or rupture of membranes, prolonged rupture of membranes (greater than 18 hours) or a maternal fever higher than 100.4 degrees during labor.”