If I'm Group B Strep Positive at 36 Weeks Gestation, Can I Still Deliver My Baby Vaginally?

I AM 36 WEEKS PREGNANT AND MY DOCTOR DID A CULTURE FOR GROUP B STREP- WHAT IS THIS AND HOW DO YOU CATCH IT? WHAT HAPPENS IF THE CULTURE IS POSITIVE? CAN I STILL DELIVER VAGINALLY? IF THE CULTURE IS POSITIVE SHOULD I BE TREATED NOW?

Group B strep is a bacteria that is normally found in 20-30 percent of women. It colonizes the vagina and the gastrointestinal tract and it is not sexually transmitted. There are thousands of bacteria that normally colonize the vagina, and Group B strep can be one of them, but we know that if this particular bacteria gets to the baby in labor, it has the potential to cause a serious infection in the baby. 1/5000 babies can get an infection with Group B strep that can cause sepsis, meningitis or pneumonia.

That is why we culture for it at 36 weeks. We want to know if you carry it, and oral antibiotics (antibiotics taken by mouth) are not effective for this bacteria. The biggest risk for GBS transmission to the baby is at the time of labor and delivery, so as long as the water is not broken it is unlikely to get to the baby. A routine swab is done at 36 weeks with a q tip that is placed in the vagina and the rectum to check for Group B strep colonization in both places.

It takes a few days to get the culture back, and if it is positive, you will be told and this information will also be transmitted to labor and delivery so they will be aware that you need treatment when you come in for labor. If you had a previous baby with Group B strep infection or if you had a urinary tract infection during this pregnancy with Group B strep you will automatically be treated with an antibiotic in labor.

There is no need to treat you for this until you go into labor or until you break your water. A positive group B strep culture should not change the way you deliver. You can still deliver vaginally. When you break your water or when you are in active labor you will be admitted to the hospital for intravenous antibiotics. The mainstay of treatment is Penicillin G, but there are alternatives if you are penicillin allergic.

When your doctor tests you for Group B strep the lab automatically tells us if your bacteria is sensitive to the alternative antibiotics if you are penicillin allergic such as clindamycin, erythromycin and vancomycin

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