Managing Group B Strep during Pregnancy

"You've tested positive for group B strep," said the voice over the phone. I considered my first pregnancy to be mostly free of the usual problems and complaints that plague other moms-to-be. Having passed all of the routine pregnancy tests with flying colors, nothing prepared me for testing positive for group B strep.

I was floored, totally unaware of what this diagnosis was, or how it could affect my unborn child and myself.

What is Group B Strep?

Group B streptococcus (GBS) is a natural bacterium found in the vagina, bowel, bladder, rectum, and throat. According to the National Organization for Rare Disorders (NORD), the streptococcus bacteria reproduce and colonize in the mucous membranes of these body parts. GBS can be transmitted through touch, air, or sexual contact. About one in four pregnant women are considered carriers of GBS but may show little or no symptoms.

Are You at Risk?

Group B strep can be detected during pregnancy through a routine swab of the vagina and/or rectum for a culture test. According to the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia, this test should be done when a woman is between 35 to 37 weeks pregnant.

When a culture test is positive, the result is that the pregnant woman is a carrier for GBS—not that she or her baby will become ill. The CDC states that pregnant women who are considered high risk for having a baby with GBS have had one or more of the following:

• Previous baby with GBS disease
• Urinary tract infection due to GBS
• GBS carriage late in pregnancy
• Fever during labor
• Rupture of membranes ("water breaks") 18 hours or more before delivery
• Labor or rupture of membranes before 37 weeks

"If you have vaginitis, cervicitis, or other infections, your risk goes up," says Dr. Tessie Tharakan, MD, a maternal-fetal medicine specialist at Columbia Presbyterian Hospital in Manhattan. In some pregnant women, GBS infection may cause urinary tract infections, endometritis, womb infections, stillbirths, and/or premature delivery if undiagnosed.

Additionally, a study published in the December 2005 issue of Obstetrics & Gynecology and conducted by Dr. Renee D. Stapleton of the University of Washington School of Medicine in Seattle, states that, "African-American women, healthcare workers, and overweight women are at increased risk for carrying group B streptococcus (GBS) during pregnancy."