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Old Jan 14th, 2011, 15:13 PM   21
PeanutBean
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I am sure you can refuse a swab but if you've other risk factors I think they will assume a positive status. However it's still up to you if you disagree with how they want to manage that.

I couldn't get to sleep last night, so much stuff was rolling around my head about this. Going to get my phone and find the pages I found last night to update this thread.



 
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Old Jan 14th, 2011, 15:24 PM   22
PeanutBean
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This one is about general sepsis, not just GBS: http://emedicine.medscape.com/article/978352-overview
There is a LOT of info in there so don't read on a sleepy head! It also uses US incidence which is higher than UK. I found it searching for a link with PROM.

I was interested in this:
Quote:
Maternal GBS status

* The most common etiology of neonatal bacterial sepsis is GBS. Nine serotypes exist, and each is related to the polysaccharide capsule of the organism. Types I, II, and III are commonly associated with neonatal GBS infection. The type III strain has been shown to be most highly associated with CNS involvement in early-onset infection, whereas types I and V have been associated with early-onset disease without CNS involvement.
I don't know if the late cultures identify the the type of GBS but now I want to know! If there are 9 and only 5 are mentioned here does that mean the other 4 are not found to cause neonatal infection?

I also noticed that right at the start it said E.coli is the second most common infection and in the 50s was the most common. Interesting in light of what the other links have said with regards to antibiotics increasing the risk of penicillin-resistant infection such as E.coli.



 
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Old Jan 14th, 2011, 15:27 PM   23
PeanutBean
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This one might seem a bit random as it's about Hong Kong where the prevalence is very low compared to in the West. http://www.hkmj.org/article_pdfs/hkm0912p414.pdf
I found it looking for any relationship between GBS swab results and recent coital activity for the simple reason that I had sex, spotted, was asked to come in and swabbed almost right away so the swab could've picked up stuff from DH or that had been temporarily introduced through sex. Don't read it all unless you're interested (it is quite interesting), the key bit for me was this in the discussion:
Quote:
There is little information regarding differences between pregnant women who have rectal versus vaginal colonisation. Meyn et al compared subjects with vaginal and rectal colonisation in non-pregnant women and found that the former was associated
with increased recent sexual activity, whereas no such association was found for the latter. Since the majority of our carriers had vaginal colonisation (92%), in our population it may be worth investigating their sexual practices during pregnancy. In a study performed in our unit a decade ago, the frequency of coitus evidently declined abruptly during the first trimester of pregnancy, and continued to decrease as gestation advanced. In the latter study, 37% and 65% of women abstained from coitus in the first and third trimesters respectively,24 in which figures are high compared to those reported for western pregnant populations. The authors have attributed this difference to conservative attitudes towards sexual activity in pregnancy as part of Chinese culture. With the increasing westernisation of our population, it is possible that sexual practices during pregnancy have also changed. Further studies on the effects of coital
frequency on the GBS colonisation rate in pregnancy are warranted.



 
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Old Jan 14th, 2011, 16:02 PM   24
PeanutBean
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This is quite an interesting (and more brief!) read. From the states.
http://www.themidwifenextdoor.com/?p=1189

This also says recent sex is an independent determinant of vaginal GBS colonization.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770838/
Quote:
Recent sexual intercourse was associated with an increased risk of vaginal GBS colonization in this study, both in the presence and absence of rectal colonization. However, there was no association with increased numbers of sexual partners or having a new sexual partner. This agrees with a recent study which reported an association between GBS incidence and increasing frequency of vaginal intercourse and other measures of sexual activity (24). Sexual activity has been linked with increased vaginal colonization by GBS in several studies (16, 17, 2426) while two studies reported no association between sexual activity and GBS colonization (27, 28). Male sexual partners of women with GBS have shown to be colonized by identical strains or serotypes suggesting sexual transmission of GBS may occur (68). Sexual activity may transmit GBS from men to women, may alter the microenvironment of the vagina in a manner that increases the persistence of GBS and/or it may enhance the transfer of microorganisms from the perineum or rectum to the vagina.



 
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Old Jan 14th, 2011, 16:08 PM   25
PeanutBean
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FAO Kandy - When I speculated about the PCR/culture testing I did have it wrong. Here;s a link showing the three tests in the UK. Our routine was is a culture but on a rubbish one, the better test is a culture in GBS specific medium. In the States PCR is used for the new rapid testing but hasn't been validated for use in the UK. SO guessing PCR might be a test method was still good of me!
http://www.gbss.org.uk/content.php?s...0&section_id=3



 
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Old Jan 15th, 2011, 11:50 AM   26
parsley
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My very good friend has strep b and was advised she needed to have iv antibiotics during the birth of her son, and that he too would need to be on them for six months (he also had an enlarged kidney). She refused both. She breastfed and still does and he is absolutely fine. she did quite alot of research about it, as her first son was a homebirth that transferred to hospital and went very wrong in her opinion. so for second birth she stayed at home and did it her way. she firmly believes your body and the natural immunity you give the baby at birth will get you through things and they are far too eager to pump you full of unnecessary drugs during highly medicalised births.



 
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Old Jan 15th, 2011, 12:02 PM   27
PeanutBean
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Thanks for your post Parsley. It's reassuring to here stories so similar to mine but that end how I hope mine will go!

I wanted to mention that I came to the conclusion reading on the GBS support service website that the charity was set up to support those who have lost babies or them been severely damaged by GBS infection which would explain why everything is nuts about getting antibiotics. A thing I read last night was all "as soon as you start labour go to hospital and tell everyone you meet that you are a GBS carrier and want antibiotics" and telling us to plaster bright stickers from them all over our notes so it doesn't get missed. I think a pretty different outlook from the way we in here feel!



 
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Old Jan 15th, 2011, 17:46 PM   28
KandyKinz
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Wow! You've definitly been busy!!!

In regards to your yogurt tampon question.... It's really easy and no more uncomfortable then just using tampons regular though it is a tad cooler which wasn't necessarily a bad thing given the discomfort of the symptoms I had been experiencing. I put a panty liner on in case of a mess but the tampon seemed to contain the yogurt to the area it needed to be in.

And I have heard of the PCR testing but had always just assumed it was more theoretical then anything else as it is something that is just never practiced here. There would certainly be advantages to rapid testing and it would be lovely to only treat women who are GBS positive at the time or labour but it would come with many draw backs as well for example even a rapid test takes time and there would be women who would not get the results fast enough to get atleast two doses of antibiotics in which is the minimum amount said to be effective at reducing the risk of gbs.... and what about women planning homebirths? Also, how you found any data which compares the accuracy of these different testing methods in detail?

And that link between sex and GBS status is certainly interesting. I've tested negative twice so far. With my first there was absolutely no sexual activity occuring near the time of the swab.. With my second there was not as much as I would have liked lol. I don't at all feel compelled to abstrain from intercourse based on those findings BUT now I definitly don't plan on doing anything sexual in the timeframe leading up to my swab. There's also benefits to sex in pregnancy as well including cervix ripening and uterine toning. I have a tendency to go late in my pregnancies. Unfortunately the obstetrical community where I am is strongly opposed to postdates and I foresee alot of conflict should I go beyond 40 weeks so I am willing to do what I can naturally to get things moving but that's another tale for another thread.....



 
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Old Jan 15th, 2011, 17:52 PM   29
KandyKinz
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http://www.springerlink.com/content/313mv1n3m8610140/

I wanted to share this study which showed that waterbirth helps to decrease the colonization of GBS on newborns. I have heard many girls on here state that they are no longer to have a waterbirth due to their positive GBS status but that contraindications seems absurd given the results of this study. But with that said the UK is still one up on Canada. At least in UK waterbirths are permitted in hospital. Here they are not regardless of GBS status



 
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Old Jan 15th, 2011, 18:04 PM   30
PeanutBean
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Kandy the GBSS link seems to imply that the ECM (was it?) and PCR are both good tests and the other, the one we do here is the one that has lots of false negatives.

I wonder if I should try a yoghurt tampon... I'd have ot buy tampons especially though and I really dislike using them when not sensitive and pregnant. Don't think I've had one since...about 15 years probably.



 
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