Group B Streptococcal Infection
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Group B Streptococcus (S. agalactiae) colonises up to 30% of pregnant women, & causes early onset infection in 0.2% of newborns. Routine culture of the maternal rectum & vagina at 35-37 weeks is not practiced in public hospitals.
Risk factors for neonatal early-onset Group B Streptococcal infection
- Spontaneous preterm labour (<37 weeks)
- In labour, with membranes ruptured ≥18 hours
- Intrapartum pyrexia ≥38 degrees C
- A previously affected baby with neonatal early onset GBS infection
- Urine, vaginal or rectal cultures positive for GBS
Women with these risk factors must be treated during labour with ampicillin 2 g IV as a single dose, followed by 1 g IV 4 hourly up to delivery. Penicillin-allergic women may receive intravenous azithromycin or vancomycin.