Group B Strep Awareness

It’s July, and that means summer fun, 100-degree+ heat and (if you’re lucky) water slides! It also means it’s International Group B Strep Awareness month, which is a very common but little-known (apart from mommies and doctors) bacteria that effects babies in utero, newborns and babies up to six months old.
Huh? What is that, and why have I never heard of it?
GBS (Group B Streptococcus), or Streptococcus agalactiae--not strep throat--is a type of bacteria that can potentially effect babies as they pass through the birth canal or when the mother’s water breaks. Though up to 25% of women have this naturally-occurring bacteria in their digestive tract and/or birth canal, few babies who are exposed become ill.

However, that illness can be severe, such as meningitis, pneumonia or a permanent handicap like blindness, deafness or cerebral palsy. In some cases, GBS has caused stillbirth or miscarriage.
It’s a good idea to get tested for GBS before your baby is born (even if you’ve been tested on a previous pregnancy, that doesn’t mean you don’t currently have GBS living in your system). There are little to no symptoms associated with GBS for the mother, with the most common being yeast-infection-like symptoms or even a bladder infection. If your doctor suspects GBS when you are pregnant and have a bladder infection, they will likely perform a urine culture apart from the routine urine tests performed on all pregnant women. In the US it’s now standard practice for GBS testing to be part of your routine prenatal testing. If you test positive for GBS, you may be placed on IV antibiotics when you go into labor. Just four hours of IV antibiotics given to the mother in labor can prevent up to 90% of newborn GBS infections. Taking these prior to the onset of labor won’t help much, as the bacteria can grow back very quickly.
Just a side note: testing positive for GBS does not mean you’ve done anything wrong during your pregnancy, or are unclean. GBS can live in just about anyone.
Now your beautiful baby has been born, and you want to provide them the absolute best in care. There are some strategies you can follow to avoid infecting your baby (not just with GBS; some of these are common-sense guidelines to protect against bacteria in general)

• Everyone, yourself included, needs to wash their hands before handling your baby. Antiseptic wipes won’t cut it--get out the soap and water.
• If you’re able to breastfeed, it’s a great choice to supply your little one with antibodies to help fight infection.
• Make sure everyone who takes care of your baby knows the symptoms of GBS infection in babies and how to respond.

Most cases of GSB will start in the first few hours after birth. Symptoms may include:

• High-pitched cry, shrill moaning, whimpering
• Constant grunting as if constipated
• Projectile vomiting
• Sleeping too much, difficulty being aroused
• High or low or unstable temperature; hands and feet may still feel cold even with a fever
• Blotchy, red, or tender skin
• Blue, gray, or pale skin due to lack of oxygen
• Fast, slow, or difficult breathing
• Body stiffening, uncontrollable jerking
• Listless, floppy, or not moving an arm or leg
• Tense or bulgy spot on top of head
• Blank stare
• Infection (pus/red skin) at base of umbilical cord or in puncture on head from internal fetal monitor
• Problems with temperature regulation
• Grunting sounds
• Fever
• Seizures
• Breathing problems
• Stiffness or extreme limpness

Of course, if you have questions about GSB it's a good idea to ask your doctor! If you'd like to read more, check out these useful sites. There's even a Facebook page:

http://www.groupbstrepinternational.org
http://www.groupbstrepinternational.org/gbs-articles/
http://www.drum.amedd.army.mil/news/2010/0710/Strep_Awareness.htm
https://www.facebook.com/GroupBStrepInternational
http://sites.conversionplanet.com/group-b-strep-awareness
http://en.wikipedia.org/wiki/Group_B_streptococcal_infection
http://groo.com/newgbsi/wp-content/uploads/2012/12/GBS_Awareness_brochure.pdf
http://www.cdc.gov/groupbstrep/index.html
http://www.strepb.ca/
http://www.aap.org/ 

Dashed Hopes: When Pregnancy Ends in Miscarriage

Linda Ratner RN, CMPE

I was healthy and relatively young by today’s standards (30).  The first trimester of my pregnancy went well and seemed very easy.  I adjusted to the minor aches and pains and life went on.  At my first appointment we saw the tiny little fetus and were instantly in love.  There, before our eyes was our beautiful little glob!

Although 1994 seems a world ago,  the pain that accompanied that year is still very present.  Not only did I lose my precious dad rather suddenly, but I also lost a pregnancy that I  carried till the second trimester.  Hopes and dreams of holding that warm cuddly baby soon were replaced by a terrible fear of the unknown.

Nearly 25% of first pregnancies end in miscarriage.  Why then, if miscarriage is so common, don’t women speak of it more often?  Why aren’t we told of the risk of miscarriage by our OBs before we get pregnant so that we are armed with knowledge?

I am surrounded by young women of childbearing age that work side-by-side with me.  Together, we have suffered the inevitable loss of their first pregnancy.  As a nurse, I comfort and reassure them that Mother Nature knows what she’s doing.  They have to trust their bodies.  I offer my personal story which culminated in the eventual birth of 3 beautiful and healthy babies (not all at once!).  It takes time,  but eventually most of us move on and go on to have healthy babies.

Today, there are so many varied advances in maternal care.  I even read about a new test that can predict an impending miscarriage by analyzing progesterone levels.  According to Ioannis Gallos, MD at the University of Oxford in England, the risk of a nonviable pregnancy was 99.2% when progesterone levels were below the cut-off (Medpage Today, Neale).  This test, combined with symptoms, can help prepare a woman and her partner for an impending miscarriage.  I say “prepare”, but how can one ever prepare for such a thing?  I don’t know about you, but for me, knowledge is empowering. Not knowing is very difficult and seems to prolong the agony.  I guess given the choice, I’d rather be able to brace myself.