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Group B streptococcal disease: screening and treatment in pregnancy

Specialist Registrar in Obstetrics and Gynaecology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Nicholas D Embleton, MD MRCPCH

Consultant in Neonatal Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Andrew D Loughney, PhD MRCOG, Consultant Obstetrician

The Royal Victoria Infirmary, University of Newcastle upon Tyne, Richardson Road, Newcastle upon Tyne NE1 4LP, UK. email: andrew.loughney{at}nuth.northy.nhs.uk (corresponding author)

Intermittent, asymptomatic colonisation of the vagina and rectum with group B streptococci is common in pregnancy. Vertical transmission of the bacterium from mother to fetus may lead to neonatal sepsis, characterised by pneumonia, meningitis and death in the most severely affected babies. Intrapartum prophylaxis with penicillin reduces the burden of disease when given to women with risk factors for the development of group B streptococcal sepsis such as preterm labour, prolonged rupture of the membranes or maternal pyrexia in labour. Some professionals advocate the universal screening of all pregnant women for group B streptococci near term and the administration of intrapartum antibiotic prophylaxis to all women testing swab-positive. This article summarises the salient features of group B streptococcal disease and explores the rationale behind the use of intrapartum antibiotics for the prevention of neonatal infection.

Keywords Keywords / group B streptococcus / intrapartum antibiotic prophylaxis / neonatal sepsis