Group step B but choosing not to have ABx

[babybear]

I was fouind to have group strep b in my urine at 16 weeks. This is being treated with oral antibiotics but I am declining to have IV antibiotic in labour if swabs are clear at 37 weeks. Anyone else?


to give you the background. I am a nurse and my partner is a microbiologist so we are well aware of the risks of not having antibiotic cover. We just believe the benefits don't out weight the risks

 

[Kai]

Even if I test positive with my next child, I won't. When I got it the first time, my arm swelled up huge and the pain from the antibiotics was worse than my back labor. My entire arm was bruised on the forearm. It was horrible.

ETA: I'm sure it was a bad reaction and this is not common. I didn't want to scare anyone. Sorry.

 

[mammym]

Hi, I'm currently 25wks pregnant with no 2, our first was born at 31 wks after slow rupture of membranes ? caused by infection. Last week I felt the same sensation of leaking water and ended up in labour ward, after 2 days and swabs and test things now appear ok. But we have been told I had grown Group B strep and would need abx in delivery. They have not sent any urine to the labs for cultures and as I understand it cannot be picked up in a normal urine dip stick? Did you ask for your urine to be tested and do you think I should? I have read that untreated GBS in the urine can cause premature labour so am worried that this is what happened last time and I really dont want the same thing happening if i could be prevented. I'm also allergic to penicillin so that makes things a little more difficult.

If you don't mind me asking, Why are you declining the abx, what are the risks? Claire.

 

[aob1013]

I have GBS, and will be going with the trained professionals advice and having the IV drip. Couldn't forgive myself if something happened to Leni that i could have prevented. GBS is dangerous. x

 

[babybear]

Hi, I'm currently 25wks pregnant with no 2, our first was born at 31 wks after slow rupture of membranes ? caused by infection. Last week I felt the same sensation of leaking water and ended up in labour ward, after 2 days and swabs and test things now appear ok. But we have been told I had grown Group B strep and would need abx in delivery. They have not sent any urine to the labs for cultures and as I understand it cannot be picked up in a normal urine dip stick? Did you ask for your urine to be tested and do you think I should? I have read that untreated GBS in the urine can cause premature labour so am worried that this is what happened last time and I really dont want the same thing happening if i could be prevented. I'm also allergic to penicillin so that makes things a little more difficult.

If you don't mind me asking, Why are you declining the abx, what are the risks? Claire.

It was found in my urine after a routine urine test. I have my urine tested monthly due to recurrent asymptomatic (no symptoms) UTIs in pregnancy. It will not specifically show up on a dipstick but it will show up as an infection in the urine which will prompt the MW to send your midwife to the lab for further testing. The best website to read is https://www.gbss.org.uk/ but ask questions and do what is best for you as only you have to live with the consequences. I am using alternative methods to rid my body of GSB (you can talk to a alternative therapist if you want to take this route (don't go believing anything thats is said on the internet). Plus having very sensitive private swabs taken at 37 weeks so I can make an informed decison. You may have it now but be totally clear at the time of delivery but it takes over 24 hours to get swab results back from the lab by which time it is too late. However studies have shown if you are found to be clear between 35-37 weeks you are 94% likely to be clear at delivery.
We have declined as for us having a UTI from GSB and getting it treated with oral antibiotics at the time should also kill off any colonisation in the vagina. GSB is transient (there one week gone the next) and so the blanket giving of MASSIVE doses of antibiotics (4mg to begin with then 1.5mg every hour till you deliver) is not necessery. This massive dose can also kill off all the good bacteria which the baby is exposed to during delivery which seed the gastrointestinal tract. Plus the vaginal exams they do in labour can cause the infection so no VEs for me.
We are aiming for a home birth too which mean they can't give IVs.
There are things that make you HIGHER risk of having a baby with early onset GSB infection
•Labour starts or membranes rupture before 37 weeks of pregnancy is completed (i.e. preterm).
•Where there is prolonged rupture of the membranes – more than 18 hours before delivery.
•Where the mother has a raised temperature* during labour of 37.8°C or higher

Wow that was an essay! Did I answer your question? As you can tell I've been doing alot of research lately.

 

[mammym]

Hi just read your post, were you offered a urine test for GBS when they found you carried it? claire

 

[babybear]

I have GBS, and will be going with the trained professionals advice and having the IV drip. Couldn't forgive myself if something happened to Leni that i could have prevented. GBS is dangerous. x

Yes GSB is dangerous but as I have said in my original post we (particularly my partner) are not exactly lay people. I am not advocating this to people at all it is a very personal decsion I was just asking if people were going down the same route as us so that we could exchange infomation

 

[babybear]

Hi just read your post, were you offered a urine test for GBS when they found you carried it? claire

No it was found on a routine urine test, no swabs have been done to date. It has been assumed that because I have a GSB UTI I am colonised. It is highly unlikely to get a GSB UTI originaiting in the kidneys to it is highly likely that 2 weeks ago I was colonised.

 

[babybear]

Hi just read your post, were you offered a urine test for GBS when they found you carried it? claire

No it was found on a routine urine test, no swabs have been done to date. It has been assumed that because I have a GSB UTI I am colonised. It is highly unlikely to get a GSB UTI originaiting in the kidneys to it is highly likely that 2 weeks ago I was colonised.

They don't check your urine for GSB as a rule, it was just inccident testing that found it

 

[mammym]

ok thanks, I'd read on the GBS site that GBS itself does not lead to pre term labour but that in the urine it can lead to urine and kidney infection, which therefore can lead to pre term labour, thats my main concern. I'm also a nurse and have dipped my own urine along with the MW and found no infection makers to suggest needing cultures as yet but may ask for one just in case. If anything it'll out my mind at ease.

What you said about the abx is interesting, I'm having repeat swabs at 28 32, and 36 weeks and seeing consultant at 30 weeks so will speak to them then. Thanks again Claire

 

[babybear]

ok thanks, I'd read on the GBS site that GBS itself does not lead to pre term labour but that in the urine it can lead to urine and kidney infection, which therefore can lead to pre term labour, thats my main concern. I'm also a nurse and have dipped my own urine along with the MW and found no infection makers to suggest needing cultures as yet but may ask for one just in case. If anything it'll out my mind at ease.

What you said about the abx is interesting, I'm having repeat swabs at 28 32, and 36 weeks and seeing consultant at 30 weeks so will speak to them then. Thanks again Claire

That is why I am taking oral ABx now to treat the UTI but refusing in labour. In this trust they don't offer repeat swabs thats why we are paying for private ones. If no nitrates (or is it nitrites I can never remember with out the tub in front of me) then you know as well as me they don't test. If your worried ask though always better to know what your dealing with then you can make an informed choice on what is best for you.

I was simply sent a letter saying we've found this you will be OFFERED IV abx then a demand to put a big sticker on my notes saying they NEEDED to give me IV abx. This is also an excellent resource from the RCOG well worth a read.

https://www.rcog.org.uk/womens-heal...-b-streptococcus-gbs-infection-newborn-babies

 

[aob1013]

I have GBS, and will be going with the trained professionals advice and having the IV drip. Couldn't forgive myself if something happened to Leni that i could have prevented. GBS is dangerous. x

Yes GSB is dangerous but as I have said in my original post we (particularly my partner) are not exactly lay people. I am not advocating this to people at all it is a very personal decsion I was just asking if people were going down the same route as us so that we could exchange infomation

I wasn't challenging you

I'm glad you brought this to light, so now i can make an informed decision x

 

[babybear]

I have GBS, and will be going with the trained professionals advice and having the IV drip. Couldn't forgive myself if something happened to Leni that i could have prevented. GBS is dangerous. x

Yes GSB is dangerous but as I have said in my original post we (particularly my partner) are not exactly lay people. I am not advocating this to people at all it is a very personal decsion I was just asking if people were going down the same route as us so that we could exchange infomation

I wasn't challenging you

I'm glad you brought this to light, so now i can make an informed decision x

Sorry, I have had to fight about this so much lately i think I automatically go on the defensive.

 

[polo_princess]

Gosh, i find you very brave, but my opinion is somewhat biased because i have seen first hand one of the worst possible outcomes of GBS.

Good luck to you, im sure you wouldnt have made an ill informed decision on something so important without doing a ton of research!!

 

[babybear]

We made the decsion after lots of reading but both said should the risk factor go up during labour then we would possibly change our mind. We are in no way doing this to prove a point but working on what risk we are willing to take. Bearing in mind that child birth in itself is a huge risk.

 

[aob1013]

I have GBS, and will be going with the trained professionals advice and having the IV drip. Couldn't forgive myself if something happened to Leni that i could have prevented. GBS is dangerous. x

Yes GSB is dangerous but as I have said in my original post we (particularly my partner) are not exactly lay people. I am not advocating this to people at all it is a very personal decsion I was just asking if people were going down the same route as us so that we could exchange infomation

I wasn't challenging you

I'm glad you brought this to light, so now i can make an informed decision x

Sorry, I have had to fight about this so much lately i think I automatically go on the defensive.

I know, it must be very hard for you to make this decision without other people interferring. If you don't mind, and if you don't have time don't worry .. but can you pass any information on to me regarding refusing it and the pro's con's? Or even just a summary

Don't want to hassle you, and only if you have the time. I'm just glad you brought this up as i don't want me or LO to have anymore injections/antib's than we have to xx

 

[polo_princess]

Its good that you are being somewhat open minded about the "what if's", a lot of people get something set into their mind and its non negotiable

Fingers crossed everything will go smoothly for you

 

[babybear]

I know, it must be very hard for you to make this decision without other people interferring. If you don't mind, and if you don't have time don't worry .. but can you pass any information on to me regarding refusing it and the pro's con's? Or even just a summary

Don't want to hassle you, and only if you have the time. I'm just glad you brought this up as i don't want me or LO to have anymore injections/antib's than we have to xx[/QUOTE]

I can give you a list of resources if you want. Alot of the reading I've done is from the hospital library so unfortuantly you won't have access but you go to any big library and look in books for trainee midwives you should be able to find info.
i can give you a list of internet sources if you like, its better to read things for yourself rather than me give you my view as you may find different aspects important to you. notice the distinction between IV abx offered, recommended and necessary.
https://www.nhs.uk/chq/pages/2580.aspx?categoryid=54&subcategoryid=137
https://www.nhs.uk/chq/pages/2037.aspx?categoryid=54&subcategoryid=137
https://www.rcog.org.uk/files/rcog-corp/uploaded-files/GT36GroupBStrep2003.pdf
https://www.aims.org.uk/Journal/Vol15No4/WarOnGroupBStrep.htm
https://www2.cochrane.org/reviews/en/ab007467.html

To give you just a few to be going on with.

 

[aob1013]

Thank you so much, i really appreciate you making the time to do that for me xx

 

[babybear]

Some of them can be a little mind blowing if your not used to reading stastics and journal articles. I find keeping a paper and pen on hand to note things down helps stop me getting bogged down and pick out what I feel is important. Oh and these resources are considered to be reliable. Ie they are not just some nobody with a computer writing anything they like this is all evidence based.