Issue link: https://cp.revolio.com/i/855118
GBS is found in the urine of 2%-7% of pregnant women. A posi ve urine test for GBS in the first trimester, also a common diagnos c method, is a marker of heavy rectal and vaginal coloniza on with GBS in the mother, and is a risk factor for early onset GBS in the newborn. Thus, it is considered an indica on for an bio c use in labor. An bio c treatment of GBS bacteriuria during pregnancy does not eliminate GBS from the genitourinary and gastrointes nal tracts, and recoloniza on a er a course of an bio cs is typical, so this does not offset the recommenda on that pregnant women with GBS in their urine receive an bio cs in labor. The above tes ng is considered highly reliable when it comes to posi ve results – in other words, if you test posi ve, you're colonized. Tes ng is done at 35-37 weeks of pregnancy, because there is a 5-week window of reliability – if you test posi ve, you're s ll likely to be posi ve for the next five weeks, allowing proper preven on to be done in labor. A nega ve test, however, does not mean you do not have the infec on; it could be what is called a "false nega ve" meaning that the test missed the infec on. You can also become colonized a er the test was done, so while your test could have been nega ve in pregnancy, you could in fact be posi ve at the me of labor. In fact, a substan al percentage of women who are ul mately GBS posi ve at the me of birth will not receive an bio cs because the presence of the bacteria was missed in pregnancy. An FDA approved rapid test can diagnose GBS in pregnant women in about an hour. It is generally recommended for use only in labor when a woman's GBS status is unknown and tes ng needs to be done rapidly for medical reasons such as premature rupture of membranes (PROM). Some studies have shown the test to be up to 91% sensi ve, even more so than the 37-37- week culture, which catches about 69% of cases. Because GBS resistance to specific an bio cs has developed, especially to those used for penicillin-allergic women, culture and sensi vity tes ng is recommended as part of the tes ng process. Should I Just Skip the Test So I Don't Know if I'm Positive? Skipping the test to avoid a posi ve result is one strategy many women ask me about and it's something that many of my home birth midwifery clients chose to do. But here's the thing: If you don't know whether you are posi ve and you're having your baby in the hospital, or need to transport from a home birth to the hospital with any risk factors for GBS including early broken waters, prolonged broken waters (> 18 to 24 hours depending on your midwifery or medical prac ce), or an elevated temperature, you're s ll going to be prescribed the an bio c. On the other hand, if you've been tested and have had a nega ve test result, then the an bio c isn't indicated and you're sort of in the clear from the decision. So, having a nega ve test result can actually be an advantage and can put your mind at ease if you're worried about being GBS posi ve. Further, if you are posi ve and know it, you can get educated about your decision, and will likely more mindful of signs of possible GBS infec on in your baby, should you choose to forego the an bio c. So, while I am not saying everyone should get tes ng, simply declining the test to avoid knowing the results isn't necessarily more effec ve for avoiding the an bio c in labor. It's sort of the same with gaming the test by using natural treatments for the few weeks before the test to achieve a nega ve test result – you might have just reduced the coloniza on so that it was low enough to give you a nega ve, but you might s ll be colonized at the me of birth and not know it. What's the Treatment & Is It Recommended for Me? As of 2002, the CDC has recommended rou ne screening for all pregnant women between 35 and 37 weeks gesta on, and universal treatment with IV an bio cs (usually penicillin or ampicillin, or an alterna ve for penicillin-allergic women) throughout labor for women who test posi ve for GBS during pregnancy. Abby's Magazine - Volume 5 Issue 4| Page 59