Group B streptococcal (GBS) infection in pregnancy

It is also called streptococcus agalactie. If there is the colonization of this bacteria in the rectum and vagina, there is the possibility of transmission of this bacteria to newborns while delivery.

so, if there is colonization, treat it

we check with a rectovaginal swab at  35 to 37-week periods of gestation (POG). GBS colonization is transient or intermittent, that's why check at 35-37 weeks POG.

Let us take one example to understand this:

A female was admitted at 38 weeks of period of gestation because of a rupture of the membrane and labor pain. Her medical history included group B streptococcal colonization at 36-week periods of gestation in her previous pregnancy. At that time, she was treated with IV penicillin. Does this time also, require penicillin?

The answer is: In this case, we do not know the colonization status of her in this pregnancy. so, we need to wait for 18 hours in this case. If she does not deliver by 18 hours, she needs to be administered empirical IV penicillin.

what are other conditions where we can give empirical antibiotics without checking colonization?

1. if there is premature rupture of membrane i.e. before 37 week period of gestation.

2. if a previous neonate with group B streptococcal infection (e.g. meningitis, pneumonia)

3. intrapartum fever

4. if she tests positive for colonization either rectovaginal colonization or urinary colonization

How to know whether her urinary tract is colonized?

if she has asymptomatic bacteriuria.

If she has a UTI due to group B streptococcal infection, obviously she needs IV penicillin.

Comments

Post a Comment

Popular posts from this blog

Image
1. How do medication, other physiological conditions like pregnancy, and pathological conditions like acute hepatitis and chronic liver disease affect thyroid hormone metabolism and the requirement of levothyroxine if the patient is already on thyroid supplements? There are some proteins in blood like thyroxine-binding globulin (TBG) that transport levothyroxine (T3, T4) In blood to peripheral tissue. pregnancy, acute hepatitis, oral contraceptive pills containing estrogen, and medications like tamoxifen, and raloxifene increase TBG. When TBG rises in the blood, TBG binds to free T3 and free T4 increasing the total T3, and T4 in the blood and decreasing the concentration of free T3, and free T4. Peripheral tissue senses the low level of free T3, and free T4, thus it stimulates the pituitary gland to produce more TSH. TSH in turn stimulates the thyroid gland to produce free T3 and free T4. 2. what are conditions where TBG decreases? a. chronic liver disease b. drugs like androgenic horm
Read more
 HERBAL SUPPLEMENTS 1. BLACK COHOSH: it has been promoted for the treatment of post-menopausal symptoms. it causes hypotension, adverse estrogenic effects, and hepatotoxicity. 2. LICORICE: it contains glycyrrhenetic acid, which inhibits the conversion of cortisol to cortisone. it is used for viral infections/ bronchitis, and stomach ulcer. 3. Ginkgo biloba: it has been marketed as an anti-oxidant, used for memory enhancement. it is also used in dementia, macular degeneration, and peripheral vascular disease. Adverse effects include increased bleeding, especially in people taking aspirin. 4. Ginseng: it is also used for memory enhancement. Side effects include increased bleeding. 5. saw palmetto: it is used for the treatment of Benign prostate hyperplasia. Its adverse effects include mild stomach discomfort and increased bleeding risk 6. St John wort: It has been marketed for use in mild to moderate depression and insomnia. it is also used as an anti-inflammatory and wound healing. Its
Read more
 psychiatry  1. definition of major depression : if 5 out of 9 symptoms persist for more than 2 weeks symptoms can be remembered with mnemonics: low mood SIGECAPS S-sleep I-loss of interest G-guilty/ worthlessness E-lack of energy C- concentration/ attention A-Appetite loss P-psychomotor changes S-suicidality Low mood In adjustment disorder, the precipitant can be anything except bereavement. what is the difference between normal grief vs major depression? In normal grief about the death of a loved one, the idea ruminates around that loved one only. she may think she would have died with her loved ones. She can feel auditory/visual hallucinations of her loved ones. But these do not significantly impair daily life functioning. these episodes occur intermittently but in major depression, these symptoms are persistent. In major depression, there is greater social and occupational dysfunction. 2. How to differentiate schizoaffective disorder from mood disorder with psychotic features and
Read more