Between 10-30% of women are colonized with Group B streptococcus (GBS). Prenatally, GBS may sometimes cause maternal urinary tract infection. It is a transient colonization (not an “infection” if it does not cause any bodily reaction), so early testing is not indicated, During labor, an infection may develop within the uterus that can present as foul smelling amniotic fluid, postpartum endometritis (infection in the lining of the uterus), or wound infection if a C-section or episiotomy is performed.
Approximately 1-2 ’70 of infants born to mothers colonized with GBS will develop early-onset invasive disease which is associated with a significant increase in infant injury and/or death. Early onset disease occurs within the first week after birth, and may present as meningitis, pneumonia or sepsis (generalized infection). Late onset GBS disease occurs between I week and several months of age in up to 20% of newborns colonized with GBS. The rate of early-onset GBS infection has diminished significantly since the initiation of antibiotic prophylaxis for those women who test positive in the last weeks of pregnancy. Treatment may also protect the woman from becoming infected.
The CDC recommends, and ACOG concurs, that all pregnant women be tested for colonization between 35-37 weeks of pregnancy, and if the test is positive, that they be treated with IV antibiotics during labor. Breath of Life Birth Center recommends this course and antibiotics are available at the center.
Because no treatment is 100% effective, the CDC recently published guidelines recommending that infants born to mothers who test positive for GBS be observed and evaluated in the hospital setting for 48 hrs following birth.
Understanding all of the above information, I/We have made the following choices:
A) __ To be tested for GBS OR _To decline testing for GBS
B) __ If I test positive for GBS, I will accept IV antibiotic treatment OR __ I will not accept treatment
C) __ If I test positive for GBS, I/we are declining hospital admission for observation / evaluation of my/our infant. However, I/we agree to have our newborn evaluated by a pediatric provider within the first 24 hours after birth. and will adhere to the center’s early discharge instruction regarding monitoring of newborn temperatures, respirations, feeding, voiding, and stooling in the first 48-72 hours, OR
__ If I test positive for GBS, because I/we prefer to have a hospital-based 48 hr observation / evaluation for our newborn, I/we understand that I would be transferred to another provider at the time of the positive result (typically 35-37 weeks) for hospital-based birth care.
Please print and bring the attached form with you to your next visit.