GBS in pregnancy - explaining the GBS.pptx

GBS

1. Group b streptococcus infection in pregnancy

2. outline Introduction and Statistics

3. outline Manifestations

4. outline Screening

5. outline Management

6. Introduction

7. Introduction Anogenital commensal NOT sexually transmitted

8. Mortality report is 0.22 per 1000 live births in 2016 and 0.61 per 1000 live births in 2017 - Risk of neonatal infection reduced about 80-95% with intrapartum antibiotics given to GBS carrier and preterm premature rupture of membrane (PPROM) woman

9. manifestations

10. feto-maternal complications due to gbs

11. Babies who get GBS may have early- or late-onset disease Early-onset disease A baby typically gets ill within 12 to 48 hours after birth or up to the first 7 days. The Lancefield Group B beta haemolytic streptococcus infection (Streptococcus agalactiae ) is recognized as the most frequent cause of severe early onset infection in new born babies Early-onset disease can cause severe complications such as Meningitis Pneumonia Sepsis A small number of babies with early-onset disease die even with immediate treatment

12. Late-onset disease A baby gets sick between a week to a few months after birth . Usually caused by contact with the mother after delivery if she is infected. May come from other sources too, such as contact with other people who have GBS. Late-onset disease is serious and may cause meningitis

13. UNIVERSAL Screening Is not Recommended Many women carry the GBS bacteria and in the majority, their babies are born safely and do not develop an infection Screening all women late in pregnancy cannot accurately predict which babies will develop GBS infection No screening test is entirely accurate: a negative swab test does not guarantee that the patient do not carry GBS Many babies who are severely affected by GBS infection are born preterm, before the suggested time for screening (35–37 weeks) Giving antibiotics to all women who carry GBS would mean that a very large number of women would receive treatment they do not need

14. HOW DO U DO h VS?

15. Insert 2cm of swab into the vagina. Rotate swab for 15 seconds, make sure it touches the walls of vagina. Withdraw the swab without touching skin and do not touch cotton end with fingers. . No need to use speculum Insert the same swab 1cm into the anus Remove the cap from sterile tube Place the swab into the tube and ensure cap fits firmly. Ensure label with name, IC and test. When feasible, specimen should be refrigerated before processing if NOT being process within 24 hours after collection.

16. INTRAPARTUM ANTIBIOTI c PROPHYLAXIS (IAP) Regimens for IAP IV Penicillin G 5 million units, followed by 2.5 million units 4 hourly until delivery OR IV Ampicillin 2g followed by 1g 4 hourly - Consider Vancomycin for patients with suspected penicillin allergy

17. POST PARTUM CARE Refer baby to paediatric team for assessment and treatment Encourage breastfeeding It is safe to breastfeed Breastfeeding has not been shown to increase the risk of GBS infection Advise on contraception (Refer MEC)