I know there is a fab Group B Strep thread stickied in here, but just looking for some reassurance/personal experience
I had a swab a few years ago (2009) when I was undergoing investigation for unexplained bleeding (all fine thankfully) and one of them came back with a 'scanty growth of GBS'
Now I know that normally an incidental finding of GBS pre-pregnancy, would not warrant any sort of treatment in pregnancy since it's unlikely I still have it now.
However, I'm not keen on leaving it to chance, and while I want to homebirth, I would want to be treated as well (so would be prepared to stamp my feet for treatment at home etc)
Am I creating a problem for myself in that a) it's unlikely I still have it, and b) if I do have it and am swabbed for it, I open myself up to having to fight for treatment at home and the chances are baby would be fine despite the strep infection? Or I am being sensible in getting swabbed late 3rd tri and then getting treatment at home? I'm so torn between trying to minimise risk, but at the same time I know that if I'd never had that swab, I'd never have known and even if I did have it baby would 99.9% likely be absolutely fine?
I appreciate it wasn't technically found in a pregnancy but the RCOG guideline states prophylactic abs are not advised for women who had a stickies GBS swab in a previous pregnancy.....
If you have a late swab and are colonised at that point you are only around 76% likely to be at the time of labour AND that doesn't mean the baby will be infected anyway. It's a tiny percentage chance even when colonised. You will not get treatment at home. It's IV abs for 4 hours minimum from the onset of labiur and the only time I've even heard of it being administered at home was when a GP friend did it herself. If you have a late swab you WILL have opposition to being at home. I've been through it with a client who had a 2 Tri positive and was harrassed to the point of freebirthing. She was threatened with being sectioned under the mental health act and with social services and so she completely disengaged from the system. It was far from ideal. Most babies infected with GBS will be born showing signs so you would simply transfer in and 90% show signs within 12 hours. Early babies and prolongeued rupture of membranes increase the risk so those are something my client took into consideration. She wouldn't have had a prem baby at home - not many would to be fair - and if her waters we gone for a long time ie 25 hours or,more with no signs of labour she would have considered treatment. When her baby was born at home, unassisted fit and well she monitored him herself every 4 hours for breathing, temp and pulse rate as they would have in hospital. They loaned her a stethoscope and gave her a chart she could fill in. All this pressure was still on her even though a late swab was negative which gives a 96% chance of there being NO colonisation in labour ie even more accurate than a positive late swab.
You can't un-know a positive test. Yes you can chose to decline their advice BUT it is not always as simple as that. You have to decide how you would deal with the pressure etc. in the event of a positive test. if you think you would decline the prophylactic abs then why do you need to know either way? Surely it's like a test for a chromosomal abnormality in some ways. Some feel there's no proving testing if they wouldn't act on a positive result. And you can have a negative test and have a poorly baby ie be one of the 6% or you could have IV antibiotics in hospital and add the addition risks of a hospital birth, where you're not mobile and STILL have a poorly baby as they don't work for everyone.
Lots to think about. It's about which risks are acceptable to you and which aren't.
Lots to think about.....but you've kind of set it straighter in my mind for me. No point causing myself a problem with a late swab when the guidelines are (for a previous finding in pregnancy) not to treat prophylatically anyway. I would be happy to monitor at home, and would be aware of the additional risk factors which I would concede to delivering in hospital with for my own peace of mind
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