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Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances.

Publication ,  Journal Article
Dotters-Katz, SK; Kuller, J; Heine, RP; Wheeler, SM
Published in: Obstet Gynecol Surv
December 2022

IMPORTANCE: Group B Streptococcus (GBS) is a common pathogen with an effective treatment. However, it remains a significant cause of neonatal sepsis, morbidity, and mortality. The screening and management of this infection are some of the first concepts learned during medical training in obstetrics. However, effective screening and evidence-based management of GBS are nuanced with many critical caveats. OBJECTIVE: The objectives of this review are to discuss the essential aspects of GBS screening and management and to highlight recent changes to recommendations and guidelines. EVIDENCE ACQUISITION: Original research articles, review articles, and guidelines on GBS were reviewed. RESULTS: The following recommendations are based on review of the evidence and professional society guidelines. Screening for GBS should occur between 36 weeks and the end of the 37th week. The culture swab should go 2 cm into the vagina and 1 cm into the anus. Patients can perform their own swabs as well. Penicillin allergy testing has been shown to be safe in pregnancy. Patients with GBS in the urine should be treated at term with antibiotic prophylaxis, independent of the colony count of the culture. Patients who are GBS-positive with preterm and prelabor rupture of membranes after 34 weeks are not candidates for expectant management, as this population has higher rates of neonatal infectious complications. Patients with a history of GBS colonization in prior pregnancy who are GBS-unknown in this current pregnancy and present with labor should receive intrapartum prophylaxis. Work on the GBS vaccine continues. CONCLUSIONS: Although all of the efforts and focus on neonatal early-onset GBS infection have led to lower rates of disease, GBS still remains a major cause of neonatal morbidity and mortality requiring continued vigilance from obstetric providers.

Duke Scholars

Published In

Obstet Gynecol Surv

DOI

EISSN

1533-9866

Publication Date

December 2022

Volume

77

Issue

12

Start / End Page

753 / 762

Location

United States

Related Subject Headings

  • Streptococcus
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Infant, Newborn
  • Humans
  • Female
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dotters-Katz, S. K., Kuller, J., Heine, R. P., & Wheeler, S. M. (2022). Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances. Obstet Gynecol Surv, 77(12), 753–762. https://doi.org/10.1097/OGX.0000000000001092
Dotters-Katz, Sarah K., Jeffrey Kuller, R Phillips Heine, and Sarahn M. Wheeler. “Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances.Obstet Gynecol Surv 77, no. 12 (December 2022): 753–62. https://doi.org/10.1097/OGX.0000000000001092.
Dotters-Katz SK, Kuller J, Heine RP, Wheeler SM. Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances. Obstet Gynecol Surv. 2022 Dec;77(12):753–62.
Dotters-Katz, Sarah K., et al. “Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances.Obstet Gynecol Surv, vol. 77, no. 12, Dec. 2022, pp. 753–62. Pubmed, doi:10.1097/OGX.0000000000001092.
Dotters-Katz SK, Kuller J, Heine RP, Wheeler SM. Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances. Obstet Gynecol Surv. 2022 Dec;77(12):753–762.

Published In

Obstet Gynecol Surv

DOI

EISSN

1533-9866

Publication Date

December 2022

Volume

77

Issue

12

Start / End Page

753 / 762

Location

United States

Related Subject Headings

  • Streptococcus
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Infant, Newborn
  • Humans
  • Female
  • 4204 Midwifery
  • 3215 Reproductive medicine
  • 1114 Paediatrics and Reproductive Medicine