Despite not having published any new material recently during my recovery and rehab following surgery, our readers have kept me VERY busy behind the scenes responding to their many queries – could be a full time job all by itself. My willingness to continue this aspect of my writing is most rewarding to me, and apparently much appreciated by our readers, and probably makes this blog relatively unique. The topics that continue to generate the most interest from past posts are: 1) Screening for chromosomal abnormalities, especially in first trimester; 2) Miscarriage and recurrent early pregnancy loss; 3) Ectopic pregnancy and use of methotrexate; 4) Group B ?-hemolytic streptococcus (GBS) infection; 5) Blood types and isoimmunization (such as Rh-disease); 6) Cervical incompetence (insufficiency) and cerclage; and, 7) Cytomegalovirus (CMV) infections.
I have received numerous individual questions and case situations which might have broad interest to our readers and would lend themselves well to new posts. Although I have shied away from public responses to these as a general approach to this blog, in view of my desire to be as ‘interactive’ as this site will allow, I have decided to make it more of the routine as I also explore new topics and updates for fresh discussion. Today I will respond to a couple queries related to GBS infection…
At Wed Feb 17, 06:03:00 PM 2010, Anonymous said… Hi I'm 37 weeks pregnant and I was tested for GBS last week and at my doctor's visit today they said I tested positive. So I was informed as to how I'll be receiving antibiotics for the GBS, but my concern is even though it will help reduce my baby’s chances of getting it, will I be completely free of it after giving birth? Also, if I'm still being sexually active with my boyfriend (father of my child), have I passed it on to him? I was told it was not sexually transmitted, but I've heard you can get it from touching and we kiss and touch all the time. So I just want to know if I've given it to him and if he needs to be tested for it and if I'll be completely treated from it after giving birth.
To Anonymous Feb 17: It is VERY hard to completely "cure" you of GBS. It is carried in the gastrointestinal tract and more than 20% of all individuals are chronic carriers. Some people keep GBS in better check than others and some can be exposed regularly and never become carriers. So, even if you are “treated” in labor, do not expect to be completely free of the bacterium. Intimate contact is probably not as important to passing GBS to other individuals as much as is their susceptibility to it. The latter is probably determined by the individual’s immune response and some folks are immunologically hyporesponsive to certain strains of GBS. With regard to transmission to others, there are many documented examples of women who were heavily colonized with GBS who did not pass the bacterium on to their partners. So there is no reason for having your partner tested at this time. I would keep up the kissing and touching and not worry about who may or may not be passing it to whom! Best wishes for the rest of the pregnancy. Dr T
At Wed Feb 24, 10:39:00 AM 2010, Anonymous said… I sure am hoping that my question gets answered. I am only 10 1/2 weeks pregnant and I am SO confused! I just got a phone call from the doctor’s office telling me I tested positive for GBS and it is so weird I just got off of ampicillin about a week ago for a urinary tract infection. But the internet makes this sound as though ‘once I am a carrier then I am always a carrier’ and the doctor’s office made it sound like I just need to take penicillin and then I don't have to worry about anything. I am really confused...which one is it? Does it go away after medication or not? Also, is it really safe to take THIS much antibiotic so early in the pregnancy? First ampicillin and now this? If antibiotics take the good bacteria as well, then how in the world can it be safe for me to take so much while still in the first trimester??? I feel bad questioning what my doctor tells me but this is my first pregnancy and I was told I would never conceive on my own... I am trying to do everything I can to just have a healthy baby... Please tell me you have some answers for me doctor?? Thank you.
To anonymous Feb 24: If you had/have a GBS urinary tract infection (UTI), that does need to be treated and can be cleared. GBS UTIs place the pregnancy at increased risks for complications including premature cervical change, preterm labor, premature rupture of membranes, early delivery and chorioamnionitis. If a GBS UTI recurs, you will need to be retreated and in some cases may need to be on 'antibiotic suppressive therapy' for the duration of the pregnancy. Penicillins are very safe to take, even in first trimester. Remember, GBS tends to be carried in the gastrointestinal tract and antibiotics usually do not successfully eradicate the bacterium from there. As you point out, broad spectrum antibiotics can harm the "good bacteria" in your vagina and allow overgrowth of the unfavorable bacteria or, more commonly, yeast. So if you develop a malodorous or itchy discharge, you need to discuss that with your doctor as well. Best wishes for the rest of the pregnancy and please let us know how things turn out. Dr T