UK Wedding News
13/09/2017
New advice published by the Royal College of Obstetricians and Gynaecologists (RCOG) has said that women who go into labour prior to 37 weeks of pregnancy should be offered antibiotics in order to prevent a possible transmission of Group B Streptococcal (GBS).
The guidance also calls for all pregnant women to be provided with appropriate information about GBS to support decision making and to raise awareness of the signs and symptoms of the infection in babies.
GBS is the most frequent cause of severe early onset infection in newborn babies. It is a bacteria that occurs naturally in the digestive system and lower vaginal tract of around a quarter of women at any one time and normally causes no harm. For pregnant women who carry GBS, the bacteria can be passed onto their baby during labour. While a vast majority will suffer no ill effects, a small proportion of these babies will develop an infection and can become seriously ill.
In 2015, around 500 babies developed the condition. With prompt treatment, 17 out of 20 diagnosed babies will fully recover, however, two in 20 babies with GBS infection will recover with some level of disability, and one in 20 infected babies will not survive.
Women are at higher risk of passing GBS onto their baby if they go into preterm labour, with 22% of all cases of early onset GBS in 2015 found in babies born prematurely. Compared to a risk of one in 2,000 for babies born at term, approximately one in 500 preterm babies will develop EOGBS disease. The mortality rate from infection increases from 2-3% for at term babies to 20-30% for those born before 37 weeks.
For this reason, the RCOG guideline now recommends all women who go into preterm labour, regardless of whether their waters have broken, receive intravenous antibiotics during labour to prevent onset of the GBS infection.
Other risk factors for EOGBS include having a previous baby affected by GBS, a positive test for GBS discovered incidentally during pregnancy, prolonged rupture of membranes and a temperature of more than 38 degrees during labour.
The updated guidance also advises that women who were known carriers of GBS in a previous pregnancy can be offered a test at 35-37 weeks of pregnancy to see whether they are still a carrier, in order to reassess whether they still require antibiotics during labour.
The revised guideline does not recommend universal bacteriological screening for GBS, in line with recommendations made by the National Screening Committee. It found that there is no clear evidence to show that routine testing would do more good than harm.
Commenting on the guideline, Professor Peter Brocklehurst, Professor of Women's Health at the University of Birmingham and a Co-Author of the guideline, said: "This guidance provides clear advice to doctors and midwives on which women should be offered antibiotics to avoid passing GBS infection onto their babies. In particular we hope to reduce the number of early onset Group B Strep infections and neonatal deaths in babies born before 37 weeks.
"The management of women whose babies are at raised risk of developing Group B Strep infection remains a vital part of reducing illness and deaths caused by this infection. Ensuring a consistent approach to care in all maternity units is vital to achieving the best outcomes for both mother and baby."
Professor Janice Rymer, Vice President of Education for the RCOG, added: "Research by the RCOG in 2015 found a large variation in UK practice about how best to prevent early onset GBS disease.
"This revised guideline will provide standardised treatment of pregnant women with GBS and reduce the risk of their babies developing the infection.
"The guideline also aims to raise awareness of GBS by recommending that all pregnant women are provided with an appropriate information leaflet, which the RCOG is now updating in line with this new guidance."
(JP)
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More Pregnant Women To Be Offered Antibiotics
New advice published by the Royal College of Obstetricians and Gynaecologists (RCOG) has said that women who go into labour prior to 37 weeks of pregnancy should be offered antibiotics in order to prevent a possible transmission of Group B Streptococcal (GBS).
The guidance also calls for all pregnant women to be provided with appropriate information about GBS to support decision making and to raise awareness of the signs and symptoms of the infection in babies.
GBS is the most frequent cause of severe early onset infection in newborn babies. It is a bacteria that occurs naturally in the digestive system and lower vaginal tract of around a quarter of women at any one time and normally causes no harm. For pregnant women who carry GBS, the bacteria can be passed onto their baby during labour. While a vast majority will suffer no ill effects, a small proportion of these babies will develop an infection and can become seriously ill.
In 2015, around 500 babies developed the condition. With prompt treatment, 17 out of 20 diagnosed babies will fully recover, however, two in 20 babies with GBS infection will recover with some level of disability, and one in 20 infected babies will not survive.
Women are at higher risk of passing GBS onto their baby if they go into preterm labour, with 22% of all cases of early onset GBS in 2015 found in babies born prematurely. Compared to a risk of one in 2,000 for babies born at term, approximately one in 500 preterm babies will develop EOGBS disease. The mortality rate from infection increases from 2-3% for at term babies to 20-30% for those born before 37 weeks.
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For this reason, the RCOG guideline now recommends all women who go into preterm labour, regardless of whether their waters have broken, receive intravenous antibiotics during labour to prevent onset of the GBS infection.
Other risk factors for EOGBS include having a previous baby affected by GBS, a positive test for GBS discovered incidentally during pregnancy, prolonged rupture of membranes and a temperature of more than 38 degrees during labour.
The updated guidance also advises that women who were known carriers of GBS in a previous pregnancy can be offered a test at 35-37 weeks of pregnancy to see whether they are still a carrier, in order to reassess whether they still require antibiotics during labour.
The revised guideline does not recommend universal bacteriological screening for GBS, in line with recommendations made by the National Screening Committee. It found that there is no clear evidence to show that routine testing would do more good than harm.
Commenting on the guideline, Professor Peter Brocklehurst, Professor of Women's Health at the University of Birmingham and a Co-Author of the guideline, said: "This guidance provides clear advice to doctors and midwives on which women should be offered antibiotics to avoid passing GBS infection onto their babies. In particular we hope to reduce the number of early onset Group B Strep infections and neonatal deaths in babies born before 37 weeks.
"The management of women whose babies are at raised risk of developing Group B Strep infection remains a vital part of reducing illness and deaths caused by this infection. Ensuring a consistent approach to care in all maternity units is vital to achieving the best outcomes for both mother and baby."
Professor Janice Rymer, Vice President of Education for the RCOG, added: "Research by the RCOG in 2015 found a large variation in UK practice about how best to prevent early onset GBS disease.
"This revised guideline will provide standardised treatment of pregnant women with GBS and reduce the risk of their babies developing the infection.
"The guideline also aims to raise awareness of GBS by recommending that all pregnant women are provided with an appropriate information leaflet, which the RCOG is now updating in line with this new guidance."
(JP)
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