Group b testing pregnancy

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

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.

How the pregnancy test was invented

If you became pregnant before the 30s of the XX century, you could reliably find out about this only by indirect signs: lack of menstruation, an increase in the abdomen, possible toxicosis, and finally, stirring. The doctor could help you by listening to the fetal heartbeat, but not so early.

Despite this, since ancient times, people have felt that pregnancy can somehow be predicted. The most surprising methods were offered, but they all had some relation to reality. nine0003

Thus, in ancient Egypt, women watered grains of wheat and barley with urine, and if she was pregnant, the grains germinated (the reliability of the test, according to later experiments conducted already in the last century, was about 40%).
Sumerian women inserted a tampon from the vagina from a herb unknown to archaeologists and wore it in themselves for three days, after which the tampon changed color in a certain way.
Hippocrates was the first to think that with the onset of pregnancy, menstruation stops (we believe that female practitioners knew about this long before him, but he at least established that this relationship is causal). nine0008
In the Middle Ages, sinful but clever nuns added wine to their morning urine and monitored the degree of transparency of the mixture: transparent means conception has taken place. This is also not entirely quackery, since the urine of a pregnant woman may react with tartaric acid in a slightly different way.

Thousands of years passed, and finally people got to the reliable methods.

First pregnancy tests

In 1927, the first real pregnancy test was invented. By this time, scientists realized that immediately after implantation of the embryo, the chorion tissue begins to produce the hormone hCG, human chorionic gonadotropin. German scientists Selmar Aschheim and Bernhard Sondek injected the urine of a pregnant woman into the body of female mice and rats, and their ovaries began to grow and produce eggs. Of course, in order to be convinced of this, the animal had to be killed and dissected. Accurate determination of pregnancy cost the lives of five mice. Expensive, and it's a pity for mice. nine0003

In addition, the test did not start working until two weeks after the delay. In the 1930s, mice were replaced by frogs, which, after being injected with hCG urine, began to spawn, so that they did not have to be slaughtered. These "live tests" could be used several times, and they gave the result faster - in 12 hours. Therefore, the novelty was cheaper, and therefore more affordable. But still, these tests could only be done in the laboratory.

A woman suspecting an unwanted pregnancy should first go to a doctor and listen to everything that he thinks about her (because the concepts of medical ethics in those years also differed from modern ones). To admit that you had sex outside of marriage or that you did not want to give birth was considered a shame; abortion has been banned in many countries. nine0003

The home pregnancy test only came about when a woman's right to privacy was recognized.

Margaret Crane and her first "predictor" of pregnancy

Margaret Crane, a twenty-six-year-old graphic designer, worked for the pharmaceutical company Organon and designed packaging for creams and lipsticks. Once she saw test tubes in the laboratory of the company - diagnostic tests for determining pregnancy: a drop of urine was added to the test tube with a reagent, and at the very bottom, in case of pregnancy, a red circle appeared two hours later. “How simple! Why not let women do it at home, so they don't have to share personal information with anyone?" thought Margaret. nine0003

Look at Margaret Crane and her invention

Margaret was not a doctor, but she was a designer, and therefore a practical savvy. Based on the container for paper clips, she created a prototype device in which the test tube could easily stand without moving for two hours. She called the device Predictor (“Predictor”), and it was very easy to use: you add urine to the test tube with the reagent, add water, shake it up and leave it for two hours, and then, thanks to the mirrored bottom, you can clearly see the red sediment at the bottom (or you don’t see it, if not pregnant). nine0003

Public reaction to Margaret Crane's invention

The bosses (mostly men) were not enthusiastic about Margaret's idea. It seemed to them that it was much more profitable to force women to go to the doctor than to sell them a portable test. And anyway, why the hell give our wives and daughters the opportunity to learn about their own future? However, Organon reported on the invention of the parent company - the Dutch Akzo. The name of the inventor was not named. European bosses gave the go-ahead to the idea, and Organon had a brainstorm about the design of the future portable test. Margaret was not even invited to the meeting, but she came there herself, and as a result, her version was selected and put into production. At 19In 71, they began to sell it - so far only in Canada. Alas, Margaret did not receive any proceeds from the sale. In the United States, the test appeared on sale only in 1977.

Of course, as in the case of contraceptives, a serious war broke out around the "Predictor". The strangest questions were asked. Will women figure out how to use it, and even in a state of agitation from a possible pregnancy? Won't some senator's daughter jump off the bridge and ruin the manufacturer? Where are the limits of women's freedom? Despite all these doubts, the buyers made a firm choice in favor of the tests, and the main target audience was not “frightened teenagers”, but married women who could not get pregnant. Again, contrary to fears, the tests did not compete with laboratory tests: on the contrary, having taken the situation under control, more and more women went to the doctor to keep their finger on the pulse and start seeing a gynecologist as soon as possible. nine0003

The history of pregnancy tests is a great example of how being informed and self-reliant can only benefit people, not harm them.

The evolution of pregnancy tests

The principle (determination and visualization of the hCG level using a reagent) remained unchanged, but the device continued to become cheaper and improved. In 1988, the first paper test strips went on sale. They had to be lowered into morning urine for 5-15 minutes. Their reliability at first was low, they gave many false negative and false positive results. At about the same time, "plates" became widespread, more precise tests in which a drop of urine had to be applied to a small plate soaked in a reagent. The device was more accurate and faster than the first strips. At 1996 invented latex test strips. The wait time has been reduced to two minutes, and the accuracy has increased to more than 95%.

Well, the next step was the invention of the familiar inkjet tests, for which it is enough to urinate on the strip for five seconds and immediately see the result. Morning urine is no longer necessary - the test can be done at any time of the day. The strips give a result comparable to the laboratory: many of them determine the level of hCG equal to 25 or even 10 subunits - and this is almost the threshold level for determining pregnancy. It is not surprising that many see the cherished (or notorious, for whom it is like) two stripes even before the delay. The ancient Sumerians could only dream of this! nine0003

As for Margaret Crane, although she did not receive money for her great invention, she married the man who decided that Organon would start producing it. They lived together for forty happy years and founded their own advertising agency in New York.

Read also:

Everything about menstruation: a detailed guide from the Euromed In Vitro clinic
These 10 problems can be completely solved if you come to the gynecologist on time! nine0008

How pregnancy tests work: how long after sex it will show the result, why it can be false negative or false positive, why the second line can be dim, whether it will show when taking hormones - 13 July 2022

produce any result?

- During pregnancy, human chorionic gonadotropin appears in the blood and urine, then - hCG (a hormone produced by the outer shell of the embryo. - Note ed. ), the doctor explains to 59.RU. - Normally, it is determined in the blood and urine of a woman only when pregnancy occurs. It reacts with a chemical reagent that is impregnated with a test strip.

Definition of pregnancy from the first day of delay. Truth or marketing?

“If the tests are good and they contain a chemical that hCG sees, then pregnancy can really be determined from the first day of the delay,” says Natalia Karmatskikh. - And when donating blood for hCG, pregnancy is determined even five to seven days before the delay. nine0003

Is delay a benchmark for a test?

The doctor explains: if unprotected sex was the day before the expected start of menstruation, the test will not show the result.

- If there was an unprotected contact, then the test, if the pregnancy has come, will show a positive result in two weeks, - explains Natalia. - This is if everything is successful - the cycle is good, they got there on time, the man has no problems and the right amount of spermatozoa. Maybe this: unprotected intercourse, but the partner used some kind of creams, from which the spermatozoa died. nine0003

“It's better to do the test in the morning” - true or myth?

It is believed that the test is best done in the morning, at the first urination, when the urine is concentrated. The doctor explains: this is not a delusion. The fact is that in the morning there is a cumulative concentration of hCG in the urine. The test can show a reliable result even during the day if the woman's kidneys work well, but the gynecologist still advises to follow the rules.

— It’s better to do the test anyway in the morning, because during the day it can be weakly positive, not appear, the girl will doubt and be nervous. In order for the result to be reliable for sure and in order not to waste a lot of nerves, it is better to do a test at the first urination, Natalia Karmatskikh clarifies. nine0003

Note that there is no recommendation not to eat or drink before testing.

Test instructions indicate 99% accuracy. Is it so?

- It depends on which company. But 99% even the best manufacturer can not give. It happens that a woman is already six weeks pregnant, and the test shows nothing, the doctor notes. - Even if contraceptives give 95-98% reliability, then it is unlikely that the test gives 9nine%. It would be more correct to say: the accuracy tends to 99%.

Why do tests get false negatives?

According to Natalia Karmatskikh, this happens if the test itself is defective (due to improper storage and other things) or if there is a small dose of hCG in the urine.

Why can the result be false positive?

- This can happen due to diseases of the ovaries and uterus - tumors, tumor-like diseases or ectopic pregnancy. And if the result is positive, but false, you need to do a smear, conduct an examination on a chair with mirrors, with your hand, be sure to do an ultrasound to see what's in the appendages, Natalya Karmatskikh recommends. nine0003

After a complex of examinations, the doctor advises to monitor hCG in dynamics by blood tests - tests will no longer be needed. If doctors suspect something, they will look at tumor markers.

In addition to diseases, menopause can also be a cause.

How do hormonal contraceptives affect test results?

When taking hormonal contraceptives, the test result can be falsely positive or falsely negative. According to the doctor, this is due to the improper use of such a remedy. With proper use, this situation can not be. nine0003

What happens if the test strip is overexposed / underexposed in urine?

When using a pregnancy test, the doctor advises you to follow the rules, because there are nuances.

- This may not affect the result if the hCG concentration is good. And if there is little hormone there or there is a frozen pregnancy, then it will be difficult to determine it in the short term, the gynecologist explains. “So it’s best to do things the right way. nine0003

I took the test and forgot about it. Is the result distorted?

If you left the test for several days, there is pregnancy, and there are no health problems, then the second strip will not go anywhere, except that it may become a little paler.

There are two lines on the test, but one is pale. What does it mean?

- This can speak not only about pregnancy, but also about tumor-like diseases of the uterus or even the intestines. There may be an ectopic pregnancy or a frozen fetus, the doctor warns. nine0196

Test prices vary. Are they any different?

The doctor explains: there is no fundamental difference in the tests, the main thing is to store them correctly. More expensive are those that reflect the result in weeks, plastic ones, but in this case the period may be calculated incorrectly.

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