Subject: Prevention of Perinatal Group B Streptococcal Disease

POLICY: Group B Streptococcal Protocol

GUIDELINES: 1. All pregnant women will be screened at 35-37 weeks gestation for vaginal and rectal GBS colonization. 

2. Women with GBS isolated from the urine in any concentration at any time during their present pregnancy should receive intrapartum chemoprophylaxis.

3. Women who have previously given birth to an infant with invasive GBS disease should receive intrapartum chemoprophylaxis.

4. If the GBS culture has not been done or the results are not known a the onset of labor they should receive intrapartum chemoprophylaxis if they have any of the following risk factors:

·         Gestation <37 weeks

·         Duration of membrane rupture >18 hours

·         Temperature of >100.4F (>38.0C)

5. Women with known negative GBS culture do not need intrapartum chemoprophylaxis even if they have any of the risk factors listed above.

PROCEDURE: 1.  All pregnant women will be screened at 35-37 weeks gestation for vaginal and rectal GBS colonization by:

·         Instruction given to patients on how to make the collection themselves at a prenatal visit

·         Collection is to be made on a transystem liquid amies polyester tipped swab transport system

·         The swab system will be sent to the lab for culture.

2. Women with a positive vaginal/rectal culture and women with a positive urine culture will be informed of the risks of GBS disease in infants and given the information and waiver sheet prior to labor.

3. If a woman chooses not to receive intrapartum chemoprophylaxis she must:

·         Verbalize understanding of the risks associated with GBS disease in infants

·         Must be willing to carefully observe and chart finding about their infant for the first 48 hours of life.

·         Must sign and initial all sites on the waiver form.

·         Must verbalize understanding of the need to reassess if any of the risk factors are present in their labor.

o   Gestation <37 weeks

o   Duration of membrane rupture >18 hours

o   Temperature of >100.4F (>38.0C)

3. If a woman chooses to receive intrapartum chemoprophylaxis she must:

·         Verbalize understanding of the desire to have at least two doses of antibiotics given, at least four hours of labor in center.

·         Be questioned about medication allergies and have noted in chart any allergies that are known.

·         Have treatment explained prior to receiving it in labor.