Group b strep labor

Group B strep infection | March of Dimes

Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns.

Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI).

While GBS may not be harmful to you, it can be very harmful to your baby. If you’re pregnant, you can pass it to your baby during labor and childbirth.

About 1 out of 4 pregnant women (25 percent) carry GBS bacteria. The best way to know if you have GBS is to get tested. If you do have GBS, though, there’s good news: your health care provider can give you treatment during labor and birth that protects your baby from GBS.

How do you get GBS?

GBS bacteria live in the intestines and the urinary and genital tracts. It lives in the body naturally. As an adult, you can’t get it from food, water or things you touch. You can’t catch it from another person, and you can’t get it from having sex.

How do you know if you have GBS?

Your provider tests you for GBS at 35 to 37 weeks of pregnancy. Testing for GBS is simple and painless. Your provider takes a swab of your vagina and rectum and sends the sample to a laboratory. Your test results are usually available in 1 to 2 days.

Your provider also can use some quick screening tests during labor to test you for GBS. But these should not replace the regular GBS test that you get at 35 to 37 weeks of pregnancy.

How can you protect your baby from GBS?

If your GBS test at 35 to 37 weeks shows you have the infection, your provider gives you medicine called an antibiotic during labor and birth through an IV (through a needle into a vein). You also may be treated if you have any risk factors for GBS and you don’t know your GBS test results or you haven’t been tested yet. Treatment with antibiotics helps prevent your baby from getting the infection.

Penicillin is the best antibiotic for most women. Another antibiotic called ampicillin also can be used. These medicines usually are safe for you and your baby. But some women (up to 1 in 25 women, or 4 percent) treated with penicillin have a mild allergic reaction, like a rash. About 1 in 10,000 women have a serious allergic reaction that needs to be treated right away. If you’re allergic to penicillin, your provider can treat you with a different medicine.

If your test shows you have GBS, remind your health care providers at the hospital when you go to have your baby. This way, you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth.

If you have GBS and you’re having a scheduled cesarean birth (c-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

It’s not helpful to take oral antibiotics before labor to treat GBS. The bacteria can return quickly, so you could have it again by the time you have your baby.

If you have GBS, what are the chances that you can pass it to your baby?

If you have GBS during childbirth and it’s not treated, there is a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

Your baby is premature. This means your baby is born before 37 weeks of pregnancy.
Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.
You have a fever (100.4 F or higher) during labor.
You’ve already had a baby with a GBS infection.
You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection.

If your baby gets GBS, do signs of infection or other problems show up right after birth?

Not always. It depends on the kind of GBS infection your baby has. There are two kinds of GBS infections:

Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby. But treatment with antibiotics during labor and birth can help prevent your baby from getting it. About half of all GBS infections in newborns are early-onset.
Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis. If you have GBS, you can pass this kind of infection to your baby during or after birth. Treatment with antibiotics during labor and birth does not prevent late-onset GBS. After birth, your baby also can get GBS from other people who have the infection.

What problems can GBS cause in newborns?

Babies with a GBS infection can have one or more of these illnesses:

Meningitis, an infection of the fluid and lining around the brain
Pneumonia, a lung infection
Sepsis, a blood infection

Pneumonia and sepsis in newborns can be life-threatening.

Most babies who are treated for GBS do fine. But even with treatment, about 1 in 20 babies (5 percent) who have GBS die. Premature babies are more likely to die from GBS than full-term babies (born at 39 to 41 weeks of pregnancy).

GBS infection may lead to health problems later in life. For example, about 1 in 4 babies (25 percent) who have meningitis caused by GBS develop:

Cerebral palsy (A group of disorders that can cause problems with brain development. These problems affect a person's ability to move and keep their balance and posture.)
Hearing problems
Learning problems
Seizures

If your baby has a GBS infection, how is he treated?

It’s important to try and prevent a newborn from getting GBS. But if a baby does get infected with early-onset GBS or late-onset GBS, he is treated with antibiotics through an IV.

If you're treated for GBS during labor, does your baby need special treatment?

Probably not. But if you have a uterine infection (an infection in your uterus) during labor and birth, your baby should be tested for GBS. Your baby’s provider can treat your baby with antibiotics while you wait for the test results.

Can GBS cause problems for mom during and after pregnancy?

GBS can cause a uterine infection during and after pregnancy. Symptoms of a uterine infection include:

Fever
Pain in your belly
Increased heart rate (During pregnancy, it also can cause your baby’s heart rate to increase.)

If you have a uterine infection, your provider can give you antibiotics, and the infection usually goes away in a few days. Some women have no symptoms, so they don’t get treatment. Without treatment, infection during pregnancy may increase your chances of:

Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
Stillbirth – When a baby dies in the womb after 20 weeks of pregnancy

If you’re treated for GBS during labor and birth, you probably won’t get a uterine infection after your baby is born.

GBS also can cause a UTI during pregnancy. A UTI can cause fever or pain and burning when you urinate. Sometimes a UTI doesn’t have any symptoms. If you have a UTI, you may find out about it from a urine test during one of your prenatal visits.

If you have a UTI caused by GBS, your provider gives you antibiotics to take by mouth during pregnancy. You also get antibiotics through an IV during labor and birth, because you may have high levels of GBS in your body.

Is there a vaccine for GBS?

No. But researchers are making and testing vaccines to prevent GBS infection in mothers and their babies.

More information

Centers for Disease Control and Prevention (CDC)

Last reviewed: November, 2013

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:

Early-onset infections, which happen during the first week of life. Babies often have symptoms within 24 hours of birth.
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

Culture for group B beta-hemolytic streptococcus (Streptococcus group B, S. agalactiae)

Method of determination The study is carried out by the method of sowing on dense nutrient media. The identification of microorganisms is carried out by mass spectrometry using a Microflex Brucker Daltonik MALDI Biotyper, BRUKER, Germany.

Test material A swab from the entrance to the vagina or anorectal area; vaginal discharge, cervical discharge

Home visit available

Synonyms: Streptococcus group B (S. agalactiae) Culture.

Brief description of the study "Culture for group B beta-hemolytic streptococcus (Streptococcus group B, S. agalactiae)"

Group B streptococcus (GBS, Streptococcus agalactiae) causes severe illness in newborns and is dangerous for certain patients other age groups.

In the vast majority of cases, newborns become infected with GBS during maternal deliveries, with a higher incidence during vaginal delivery. GBS causes early neonatal infections such as sepsis, meningitis, pneumonia, osteomyelitis, arthritis, and pyelonephritis, with rates ranging from 0.2 to 5 or more per 1,000 live births in different countries. In obstetric practice, group B streptococcus is associated with bacteremia, urinary tract infections, chorioamnionitis, premature rupture of amniotic fluid, preterm labor, postpartum endometritis, etc.

GBS in the human body can colonize the oropharynx, anal area of the rectum, vagina (usually vestibule), urogenital tract, skin.

It has been established that GBS in 5-35% of women can be detected in the vagina and often in the urethra of their sexual partners A significant association of carriage of GBS in the vagina has been shown not only with early septicemia of newborns, but also with spontaneous miscarriages, premature birth, premature rupture of amniotic fluid , urinary infection in pregnant women, the birth of children with low body weight, the development of chorioamnionitis in childbirth, endometritis and sepsis in puerperas. The highest level of colonization in women of reproductive age and pregnant women. In pregnant women, GBS is isolated from the listed areas in 7-30% of cases (more often in young people who have high sexual activity or use intrauterine contraceptives). Of these, 60-75% remain GBS carriers until the end of pregnancy.

Vaginal-rectal swabs are collected to detect colonization of the vagina of pregnant women with group B streptococcus. In all other cases, the biomaterial is taken only if there are clinical signs of infection.

GBS has a natural sensitivity to beta-lactam antibiotics, including penicillins. Determination of sensitivity is necessary in cases where the patient has an individual intolerance to drugs of this group.

Isolateable microorganisms and pathogens:

Streptococcus agalactiae.

What is the purpose of culture for group B beta-hemolytic streptococcus (Streptococcus group B, S. agalactiae)? in order to identify bacteriocarrier and determine the need for antibiotic prophylaxis during childbirth, to prevent neonatal complications (septicemia, pneumonia and neonatal meningitis).

What can affect the result of the test "Culture for beta-hemolytic streptococcus group B (Streptococcus group B, S. agalactiae)"

Failure to follow the rules for preparing for the study may affect the result of the test.

Streptococcus agalactiae (group B haemolytic streptococcus), antigen

Test to detect and confirm infection with group B hemolytic streptococcus (Streptococcus agalactiae).

Synonyms Russian

Group B streptococcus, B-hemolytic streptococcus group B, GBS.

Synonyms English

GBS.

Research method

Immunochromatography.

What biomaterial can be used for research?

Urogenital swab, swab from the inner surface of the cervix (from the cervical canal).

How to properly prepare for an examination?

For women, it is recommended to perform a study before menstruation or 2-3 days after it ends.
Men do not urinate for 3 hours prior to examination.

General information about the study :

Streptococcus agalactiae (Group B Streptococcus, GBS) are Gram-positive facultative anaerobes that do not form spores. It is an important pathogen that colonizes the urogenital and lower gastrointestinal tracts. It is believed that about 40% of healthy women of reproductive age are infected with Streptococcus agalactiae. Streptococcus agalactiae is the main cause of sepsis and meningitis in newborns. In addition, group B B-hemolytic streptococcus can infect the elderly and immunocompromised adults. GBS can form biofilms that enhance its colonizing properties and contribute to the persistence of the pathogen in the host organism.

In most cases colonization of the urogenital tract and rectum is considered as asymptomatic carriage. Manifestations of infection in adults include bacteremia, skin and soft tissue infections, pneumonia, osteomyelitis, urinary tract infections, necrotizing fasciitis, myositis, sepsis, arthritis, prostatitis. However, group B streptococcus is most dangerous for newborns. Until now, Streptococcus agalactiae occupies one of the leading places in the structure of pathogens of perinatal infections. Most often, a child becomes infected with GBS during childbirth, its transmission from mother to child occurs in 37-75% of cases. Intrauterine transmission of GBS is possible, which can cause miscarriages, miscarriages, and stillbirths. Risk factors for infection in a child born to a mother with GBS include age of pregnancy (less than 20 years), history of miscarriage or medical abortion, amnionitis, preterm birth (before 37 weeks), fever during labor, prolonged anhydrous period, intrauterine growth retardation etc. The more massive the GBS colonization of the skin and mucous membranes of newborns, the greater the likelihood of developing an infectious process. Streptococcal infection can occur in two forms: 1) in the first 48 hours of a newborn's life and manifest itself as septicemia or pneumonia; 2) and with a later onset and proceed in the form of meningitis. With a fulminant form of the disease, mortality among newborns reaches 60%. To prevent transmission of infection from mother to fetus, antibiotic prophylaxis with penicillin is recommended at 35-37 weeks of gestation in women diagnosed with GBS in swabs from the urogenital tract and / or rectum.

There is currently no widespread screening for Streptococcus agalactiae in Russia. Due to the low specificity of the manifestations of infection, laboratory diagnostic methods are of particular importance in verifying the diagnosis. For this test, an immunochromatographic method is used using Vedalab test cassettes (France). Test sensitivity - 10 ³ -10 ⁴ bacterial cells per 0.1 ml of sample. This is a rapid screening test for β-hemolytic streptococcus.

What is research used for?

For the early detection of Streptococcus agalactiae in order to prevent infection of the fetus.
To reduce morbidity and mortality from perinatal S. agalactiae infection.
To detect infection in elderly and immunocompromised individuals.

When is the test scheduled?