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Group B Strep and Pregnancy (for Parents)

What Is Group B Strep?

Group B Streptococcus (group B strep, GBS) is a type of

bacteriaoften found in the urinary tract, digestive system, and reproductive tracts. The bacteria come and go from our bodies, so most people who have it don't know that they do. GBS usually doesn't cause health problems.

What Problems Can Group B Strep Cause?

Health problems from GBS are not common. But it can cause illness in some people, such as the elderly and those with some medical conditions. GBS can cause infections in such areas of the body as the blood, lungs, skin, or bones.

About 1 out of every 4 women have GBS. In pregnant women, GBS can cause infection of the urinary tract, placenta, womb, and amniotic fluid.

Even if they haven't had any symptoms of infection, pregnant women can pass the infection to their babies during labor and delivery.

How Does Group B Strep Affect Babies?

When women with GBS are treated with antibiotics during labor, most of their babies do not have any problems. But some babies can become very sick from GBS. Premature babies are more likely to be infected with GBS than full-term babies because their bodies and immune systems are less developed.

The two types of GBS disease in babies are:

  1. Early-onset infections, which happen during the first week of life. Babies often have symptoms within 24 hours of birth.
  2. Late-onset infections, which develop weeks to months after birth. This type of GBS disease is not well understood.

What Are the Signs & Symptoms of GBS Disease?

Newborns and infants with GBS disease might show these signs:

  • a fever
  • feeding problems
  • breathing problems
  • irritability or fussiness
  • inactivity or limpness
  • trouble keeping a healthy body temperature

Babies with GBS disease can develop serious problems, such as:

  • pneumonia
  • sepsis
  • meningitis (infection of the fluid and lining around the brain). Meningitis is more common with late-onset GBS disease and, in some cases, can lead to hearing loss, vision loss, learning disabilities, seizures, and even death.

How Is Group B Strep Diagnosed?

Pregnant women are routinely tested for GBS late in the pregnancy, usually between weeks 35 and 37. The test is simple, inexpensive, and painless. Called a culture, it involves using a large cotton swab to collect samples from the vagina and rectum. These samples are tested in a lab to check for GBS. The results are usually available in 1 to 3 days.

If a test finds GBS, the woman is said to be "GBS-positive." This means only that she has the bacteria in her body — not that she or her baby will become sick from it.

GBS infection in babies is diagnosed by testing a sample of blood or spinal fluid. But not all babies born to GBS-positive mothers need testing. Most healthy babies are simply watched to see if they have signs of infection.

How Is Group B Strep Treated?

Doctors will test a pregnant woman to see if she has GBS. If she does, she will get intravenous (IV) antibiotics during labor to kill the bacteria. Doctors usually use penicillin, but can give other medicines if a woman is allergic to it.

It's best for a woman to get antibiotics for at least 4 hours before delivery. This simple step greatly helps to prevent the spread of GBS to the baby.

Doctors also might give antibiotics during labor to a pregnant woman if she:

  • goes into labor prematurely, before being tested for GBS
  • hasn't been tested for GBS and her water breaks 18 or more hours before delivery
  • hasn't been tested for GBS and has a fever during labor
  • had a GBS bladder infection during the pregnancy
  • had a baby before with GBS disease

Giving antibiotics during labor helps to prevent early-onset GBS disease only. The cause of late-onset disease isn't known, so no method has yet been found to prevent it. Researchers are working to develop a vaccine to prevent GBS infection.

Babies who get GBS disease are treated with antibiotics. These are started as soon as possible to help prevent problems. These babies also may need other treatments, like breathing help and IV fluids.

How Can I Help Prevent Group B Strep Infection?

Because GBS comes and goes from the body, a woman should be tested for it during each pregnancy. Women who are GBS-positive and get antibiotics at the right time during labor do well, and most don't pass the infection to their babies.

If you are GBS-positive and begin to go into labor, go to the hospital rather than laboring at home. By getting IV antibiotics for at least 4 hours before delivery, you can help protect your baby against early-onset GBS disease.

Reviewed by: Thinh Phu Nguyen, MD

Date reviewed: July 2022

Group B Strep In Pregnancy: Test, Risks & Treatment

Overview

What is group B strep?

Group B strep infection (also GBS or group B Streptococcus) is caused by bacteria typically found in a person's vagina or rectal area. About 25% of pregnant people have GBS, but don't know it because it doesn't cause symptoms. A pregnant person with GBS can pass the bacteria to their baby during vaginal delivery. Infants, older adults or people with a weakened or underdeveloped immune system are more likely to develop complications from group B strep.

Most newborns who get GBS don't become sick. However, the bacteria can cause severe and even life-threatening infections in a small percentage of newborns. Healthcare providers screen for group B strep as part of your routine prenatal care. If you test positive, your provider will treat you with antibiotics.

How do you get group B strep?

GBS bacteria naturally occur in areas of your body like your intestines and genital and urinary tracts. Adults can't get it from person-to-person contact or from sharing food or drinks with an infected person. Experts aren't entirely sure why the bacteria spreads, but they know that it’s potentially harmful in babies and people with weakened immune systems.

When do you get tested for group B strep?

The Centers for Disease Control and Prevention (CDC) recommends routine screening for group B strep in all pregnancies. You're screened for GBS between 36 and 37 weeks of pregnancy. Group B strep testing involves your provider taking a swab of your vagina and rectum and then sending it to a lab for analysis.

Can Group B strep affect a developing fetus?

GBS doesn't affect the fetus baby while it's still inside your uterus. However, your baby can get GBS from you during labor and delivery. Taking antibiotics for GBS reduces your chances of passing it to your baby.

How does a baby get GBS?

There are two main types of Group B strep in babies:

  • Early-onset infection: Most (75%) babies with GBS become infected in the first week of life. GBS infection is usually apparent within a few hours after birth. Premature babies face greater risk if they become infected, but most babies who get GBS are full-term.
  • Late-onset infection: GBS infection can also occur in infants one week to three months after birth. Late-onset infection is less common and is less likely to result in a baby's death than early-onset infection.

How common is GBS?

Group B strep screening during pregnancy has decreased the number of cases. According to the CDC, about 930 babies get early-onset GBS, and 1,050 get late-onset GBS. About 4% of babies who develop GBS will die from it.

Symptoms and Causes

What are the symptoms of group B strep?

Most adults don't experience symptoms of group B strep. It can cause symptoms in older people or people with certain medical conditions, but this is rare. These symptoms include:

  • Fever, chills and fatigue.
  • Difficulty breathing.
  • Chest pains.
  • Muscle stiffness.

Newborns with GBS have symptoms like:

  • Fever.
  • Difficulty feeding.
  • Irritability.
  • Breathing difficulties.
  • Lack of energy.

These symptoms can become serious quickly because newborns lack immunity. Group B strep infection can lead to severe problems like sepsis, pneumonia and meningitis in infants.

Can I pass group B strep to my partner?

Other people that live with you, including other children, aren't at risk of getting sick.

Diagnosis and Tests

Will I be tested for group B strep?

Yes, your healthcare provider will test you for GBS late in your pregnancy, around weeks 36 to 37.

Your obstetrician uses a cotton swab to obtain samples of cells from your vagina and rectum. This test doesn't hurt and takes less than a minute. Then, the sample is sent to a lab where it's analyzed for group B strep. Most people receive their results within 48 hours. A positive culture result means you're a GBS carrier, but it doesn't mean that you or your baby will become sick.

If you’re using a midwife, you might be given instructions on how to test yourself at home and submit the swab to a lab.

Is Group B strep an STI?

No, group B strep isn't an STI (sexually transmitted infection). The type of bacteria that causes GBS naturally lives in your vagina or rectum. It doesn't cause symptoms for most people.

Management and Treatment

What happens if you test positive for group B strep during pregnancy?

Healthcare providers prevent GBS infection in your baby by treating you with intravenous (IV) antibiotics during labor and delivery. The most common antibiotic to treat group B strep is penicillin or ampicillin. Giving you an antibiotic at this time helps prevent the spread of GBS from you to your newborn. It's not effective to treat GBS earlier than at delivery. The antibiotics work best when given at least four hours before delivery. About 90% of infections are prevented with this type of treatment.

One exception to the timing of treatment is when GBS is detected in urine. When this is the case, oral antibiotic treatment begins when GBS is identified (regardless of the stage of pregnancy). Antibiotics should still be given through an IV during labor.

Any pregnant person who has previously given birth to a baby who developed a GBS infection or who has had a urinary tract infection in this pregnancy caused by GBS will also be treated during labor.

How is group B strep treated in newborns?

Some babies still get GBS infections despite testing and antibiotic treatment during labor. Healthcare providers might take a sample of the baby's blood or spinal fluid to see if the baby has GBS infection. If your baby has GBS, they're treated with antibiotics through an IV.

Prevention

How can I reduce my risk of group B strep?

Anyone can get GBS. Some people are at higher risk due to certain medical conditions or age. The following factors increase your risk for having a baby born with group B strep:

  • You tested positive for GBS.
  • You develop a fever during labor.
  • More than 18 hours pass between your water breaking and your baby being born.
  • You have medical conditions like diabetes, heart disease or cancer.

Getting screened for GBS and taking antibiotics (if you're positive) is the best way to protect your baby from infection.

Outlook / Prognosis

What are long term problems of Group B strep in newborns?

Infants with GBS can develop meningitis, pneumonia or sepsis. These illnesses can be life-threatening. Most infants don't develop any long-term issues; however, about 25% of babies with meningitis caused by GBS develop cerebral palsy, hearing problems, learning disabilities or seizures.

Can I get tested for group B strep again?

No, once you test positive for GBS, you're considered positive for the rest of your pregnancy. You will not get re-tested.

Do I need treated for group B strep if I am having a c-section?

No, you don't need antibiotics if you're having a c-section delivery. However, you'll still be tested for GBS because labor could start before your scheduled c-section. If your water breaks and you're GBS positive, your baby is at risk of contracting the disease.

Living With

When should I see my healthcare provider if I’m positive for group B strep?

In some cases, GBS causes infections during pregnancy. Symptoms of infection include fever, pain and increased heart rate. Let your provider know if you have any of those symptoms as it could lead to preterm labor.

GBS can also cause urinary tract infection (UTI), which requires oral antibiotics.

Talk to your provider about what you can expect during labor and delivery if you have group B strep.

A note from Cleveland Clinic

Try not to panic if your healthcare provider tells you you're positive for group B strep during pregnancy. It's caused by bacteria that occur naturally in your body, not by anything you did wrong. The chances of you passing group B strep to your baby are quite low, especially if you take antibiotics during labor. Talk to your provider about group B strep and share any concerns you have. In most cases, testing positive for GBS causes no problems, and your baby is healthy.

Inventory card | Knowledge Base | GBS.Market

Inventory is the process of recalculating inventory balances. In the process of recounting, surpluses, shortages or re-sorting of goods that are in the warehouse of the outlet are revealed.

In GBS.Market, inventory is carried out in the inventory card. You can open it:

  • From the main form menu: Documents - New Inventory
  • From the inventory log: “Add” button

Inventory card appearance

Inventory card consists of three sections

  • Inventory parameters page
  • Inventory process page

    Page "Inventory parameters"

    The page with inventory parameters looks as shown in the screenshot below. nine0005 Inventory parameters

    The following parameters are available for setting:

    • Product categories
    • Warehouse
    • “Load products with inventory less than or equal to zero” option

    Categories

    for which the balance will be recalculated.

    Selection of categories for inventory

    In the selection list of categories, mark the necessary ones. nine0005

    Inventory can only be carried out for the balance of goods in the same warehouse. You must select the warehouse for which the revision will take place.

    If you didn't create additional warehouses, there will be only one.

    Load goods with stocks less than or equal to zero

    that have a zero or negative remainder.

    If the option is disabled, only products with a positive balance will be loaded into the list. nine0005

    Click the "Next" button to go to the list of items to be inventoried.

    Take Inventory Page

    The Take Inventory page displays a list of items, control buttons, a search box, and other controls. The page looks like the screenshot below.

    Take Inventory Page

    Form Menu

    The following options are available on the Form Menu:

    • File
      • Save as . .. - allows you to save the contents of the list in Excel/CSV Format

    In the case of the integration with Barcode Harvester, points will be available:

    • 9000
    • 9000 9000 9000 9000 9000

    "Search/Barcode" block

    In the "Search/Barcode" panel there is a field for searching and parameters of program behavior. Click on the “settings” button to show more options. nine0005

    "Search/barcode" field

    The "search/barcode" field allows you to change the quantity of goods on the balance using a barcode or filter the list by the name/part of the barcode.

    If the barcode of the item is scanned in the field, the value of “balance after the fact” will be increased by 1 pc.

    If a weight barcode is scanned, the value of the field “remainder after the fact” will be increased by the amount indicated in the barcode.

    If a part of a product name or a part of a barcode is entered in the field, then the list of products will be filtered, the values ​​of the “remaining after the fact” fields will not be changed for any product. nine0005

    When scanning the barcode, request the quantity

    If this option is enabled, then when scanning a barcode, instead of increasing the value of “residual balance”, a window will be displayed for entering the quantity of goods found by matching the barcode.

    Entering the value "remaining after the fact"

    In the window that appears, you must set the quantity of goods that is in stock.

    For identical barcodes, fix the number for the first match

    If the option is enabled, and more than one match is found by the barcode, the program will increase (or request) the actual balance for the first entry in the list. nine0005

    If the option is disabled, then the field “remaining after the fact” will not be changed, and the list of goods will show those items that were found.

    Do not show notifications

    If this option is enabled, then notifications about balance changes will not be shown.

    If the option is disabled, the program will notify you about the successful change in the value of “actual balance”.

    Notification appearance

    List of goods

    An example of a list of goods for which inventory is performed is shown in the screenshot below. nine0005 List of goods in the inventory window

    in the list are a standard set of fields:

    • barcode
    • Category of goods
    • Name of goods
    • 9000 quantity of goods entered during the inventory
    • Balance in the database is the number of goods that should be in stock at the current time according to information from the database
    • The difference is the difference between the actual balance and the base balance. If the value is negative, there is a shortage of goods. If positive - excess.

    The value of the field “Balance after the fact” can be set in inline editing mode directly in the table.

    Edit

    Select one or more items to change their actual balance value.

    Enter balance for multiple items

    You can also double-click on an item in the list to display the quantity change form. nine0005

    Delete

    Select one or more items in the list to delete them.

    It is important to understand that the selected items will only be removed from the inventory list and not from the item catalog. Those. at the end of the inventory, the balances of these products will NOT be adjusted, while the products will remain in the catalog.

    Total row

    The total row displays the total values ​​for the positions in the list:

    • total retail value of goods in fact and in the database
    • number of items
    • balance in fact and in the database

    When you click on the “Update balance from database” button, the value of the “base balance” field will be updated. This can be useful when the balance value for items has changed during the inventory process.

    Completion of the inventory

    When you click on the “Next” button on the inventory page, the inventory completion window will open. nine0005 Inventory completion window

    Comment

    In the comment field, you can enter some note about the ongoing inventory.

    Finish

    When you click on the “Finish” button, the inventory document will be saved to the database. For goods that were in the list for recalculation of balances, the balances will be adjusted according to the value of the field “balance after the fact”.

    Important If for some goods you have not changed the value of the field "balance after the fact", then their balances in the database will be set to zero. Before saving the inventory, make sure that you have correctly entered the value of the "remaining after the fact" field. nine0005

    Inventory deletion will be required to restore zero balances.

    You can view the balance of goods in the catalog of goods, and the fact of the inventory will be displayed in the journal in the product card.

    Suspend

    If you select Suspend, the physical inventory document will be saved with the status Draft.

    The balance of goods for which recalculation is taking place will not be changed. An inventory with this status can be continued from the inventory log. nine0005

    Cancel

    The inventory completion form will be closed so that you can continue working with the current list of items. The inventory itself will not be canceled when this button is pressed.

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