Common bacteria found in the genital tract (20-40% of women)

Pathophysiology

• Group B streptococcus (GBS) is a commensal bacterium found in the vagina or rectum of ~25% of pregnant women
• In most cases, this colonisation causes no symptoms or sequelae
• However, sometimes, particularly in the presence of certain risk factors, GBS can cause an infection (typically sepsis, pneumonia, or meningitis) in the neonate - early onset GBS disease of the newborn
  • Risks increase with pre-term birth, prolonged ROM, raised temperature

Investigations

• Vaginal and rectal swabs: culture or PCR
• RCOG recommends that it is not screened for routinely, so only women identified as being high risk for GBS infection will be tested
  • May include those with symptoms of UTI or chorioamnionitis during pregnancy, those with STI symptoms pre-pregnancy or those with a previous GBS infected baby

Management

• Offer intrapatrum antibiotic prophylaxis (benzylpenicillin or clindamycin) if:
  • GBS detected antenatally
  • Previous baby has been affected by GBS infection
  • Delivery <37 weeks
• If chorioamnitis - consider broad spectrum antibiotics