GBS and antibiotics

I had my 34 week appointment yesterday and the topic of GBS came up. I have been tested twice this pregnancy when I was in the hosp for PTL. Once at 26weeks and one at 30weeks 6 days. Both were negative. My Dr told me yesterday that he would expect me to go into labor in the next week or 2. He said that the previous GBS tests don't count and I have to have another at 35 weeks. If I go into labor before that then they automatically give me antibiotics. I am totally against taking antibiotics for no reason at all. I called today to discuss it more with my OB (I don't know why I didn't yesterday) but he is not in so a nurse is supposed to call me. I have no problem getting the antibiotics if I should come up positive, but why can't I be tested now especially if labor is imminent? I understand the test is valid for several weeks. Any experience with this and when the test was done?

 

Why didn't he test you yesterday at your appointment then? I was positive with my 1st prgnancy so they say no matter what they will treat for it now. Hopefully you'll get some answers from the nurse.

 

I was tested at 33 weeks and got a negative result, but my doctor said that if the babies came before ~35 weeks they might still give antibiotics because there is some small risk of a false negative and the babies would be especially vulnerable if they were born this early. Maybe your doctor is also thinking along these lines?

 

Maybe so.. glad to see you are still hanging in there!! When is your Dr thinking the babies may come? Mine thinks a week maybe 2.

 

Thanks! I haven't gotten any kind of estimate, but I wouldn't be surprised if it was in the next week or two

 

here's the plain language summary on an overview of studies on antibiotics & GBS from the Cochrane Library:

"Women, men and children of all ages can be colonized with Group B streptococcus (GBS) bacteria without having any symptoms; bacteria are particularly found in the gastrointestinal tract, vagina and urethra. This is the situation in both developed and developing countries. About one in 2000 newborn babies have Group B streptococcus bacterial infections, usually evident as respiratory disease, general sepsis, or meningitis within the first week. The baby contracts the infection from the mother during labor. Giving the mother an antibiotic directly into a vein during labor causes bacterial counts to fall rapidly, which suggests possible benefits but pregnant women need to be screened. Many countries have guidelines on screening for GBS in pregnancy and treatment with antibiotics. Some risk factors for an affected baby are preterm and low birthweight; prolonged labor; prolonged rupture of the membranes (more than 12 hours); severe changes in fetal heart rate during the first stage of labor; and gestational diabetes. Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug-resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.

This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. The antibiotics ampicillin and penicillin were no different from each other in one trial with 352 GBS positive women. All cases of perinatal GBS infections are unlikely to be prevented even if an effective vaccine is developed."

you can take a look at the whole abstract here. even with a positive GBS test, there's a chance you could be GBS negative by the time you go into labor. i would ask your doctor about the possibility of taking an expectant management (observation & treatment is only offered if symptoms arise) vs a prophylactic management (treatment with or without symptoms) approach to it & see what he says.