Some individuals are advised to have testing for Group B Strep (GBS) in their current pregnancy听between 35-37听weeks:听
- You were identified to have had a positive GBS听result听in a previous pregnancy听听
- A previous baby was diagnosed and treated听for GBS Positive result听听
- GBS was identified by chance earlier in your pregnancy听either in your urine or from a swab听and you are being offered a repeat test听
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A Brief Summary of What is GBS and Why test for it?听听
Group B Streptococcus听(GBS)听is normally a harmless and听common bacteria听which may be identified in your urine or from a听vaginal听and/or鈥痳ectal swab, it effects听2鈥�4 in 10 women (20鈥�40%) in the UK听and usually causes no harm to that individual, there are no symptoms and it is not a sexually transmitted infection.听听
Whilst carrying GBS is usually听harmless听pre-pregnancy or during pregnancy,听it may听affect your baby around the time of birth.听Whilst most babies are born safely and will not develop听GBS,听occasionally听it can cause听serious infection in newborn babies.听
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When and how do you test for GBS?听听
Routine testing of all pregnant individuals听is not听generally听recommended in the UK听as GBS is a transient organism听(can come and go),听screening听is currently based upon risk factors听as stated above.听
Where individuals听choose to undertake the test, this is normally recommended between 35-37 weeks gestation (32-34 weeks for twins).听The test involves taking a swab from both the lower vaginal听and anal/rectal areas听(see below), and this听test will tell you if GBS bacteria is currently present at that time of testing.听听
For more information about available听self-testing, not through the NHS, visit the Group B Strep Support (GBSS) website:听听听
Sometime GBS can be detected by chance in a听urine sample,听when a healthcare professional听sends a sample off for screening for a suspected urinary tract infection. If this is detected in your urine, oral antibiotics will be听advised听and you will be offered听intravenous (IV)听prophylactic antibiotics in labour.听听
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Instructions for the collection of a low vaginal and anorectal swab for the detection of Group B Streptococcus (GBS)听
You will have been provided with a swab to undertake self-testing procedure to determine if you have a current presence of the group B Streptococcus (GBS) bacterium present within your vagina or bowel. Please read all instructions before collecting specimens. If you have any questions about this procedure, please ask your midwife or doctor.听
- Wash hands with soap and water, rinse and dry.听
- Unpack the kit on a clean surface, ideally near a toilet and remove underwear.听
- It is important to maintain a comfortable balance during the collection procedure.听
- Twist the cap to break the seal of the swab. Pull the cap with attached swab off the tube. Do not touch the soft tip or lay the swab down. If you touch or drop the swab tip or the swab is laid down, discard and request a new vaginal swab from your midwife.听
- Hold the swab听by听the cap with one hand so the swab is pointing toward you.听
- With your other hand, gently spread the skin of the labia. Insert the tip of the swab into the vaginal opening. Point the tip toward your lower back and relax your muscles.听
- Gently slide the swab听around听2cm into the vagina. If the swab does not slide easily, gently rotate the swab as you push. If it is still difficult, do not attempt to continue and seek advice from your midwife.听
- Make sure the swab touches the inside walls of the vagina so that moisture is absorbed.听
- Rotate the swab for 10-15 seconds听around the front, sides and back of the vagina听and then withdraw the swab.听
- Insert听the same swab听gently into the anus so that around 1cm of the swab is within the rectum.听
- Rotate the swab for 10-15 seconds and then withdraw the swab.听
- Return the swab to the tube and cap securely.听
- After听collection, wash hands with soap and water, rinse and dry.听
- Apply a patient ID label from the request from to the side of the tube and seal within a transport bag. Return the sample with the request form to your midwife or doctor.听
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How to听store the sample if done at home and not in the hospital or during a community midwife听appointment.听听
Ideally, you should deliver the sample to Antenatal Clinic reception, MAC or Delivery Suite as soon as possible after the sample has been taken. If you cannot deliver the sample immediately it should be stored in a fridge at around 4掳C, but for no longer than 24 hours. Place the sample in an extra plastic bag before putting it in the fridge.听
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What happens next?听
The sample will be tested at the pathology department at 51猎奇 District Hospital. Your results will normally be reported within 72 hours after the pathology department has received your sample.听
Results will be checked by your midwife or听doctor听and we will contact you if the test results suggest further action is needed. Normally, no treatment will be required until presenting in labour.听If you have been informed听of a GBS positive result,听it is important that you make staff aware of this when contacting the maternity unit, if your waters break, if you feel unwell or when presenting in labour.听
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What happens to my sample after it has been tested?听
Once your sample has been tested and a result has been sent back to your referring doctor or midwife, the remaining sample will be disposed of with the other laboratory waste.听
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What does the test result mean?听听
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If your result is GBS Negative听听
This means that the test has not managed to isolate the organism and it is likely that you do not currently have GBS within your vagina or bowel. No听further action is required and there should be no听change to your labour management.听听
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If your result is GBS Positive听听
This means that GBS has been found within听your vagina or bowel. There听is a small chance听of this being passed to your baby during the birth, and听you are recommended to have antibiotics in labour听to reduce the risk of transmission.听听
Antibiotics reduce the risk of your baby developing a GBS infection in their first week of life from around 1 in 400 to 1 in 4000.听Ideally antibiotics听(penicillin, or suitable alternative if you are allergic)听should be given听at least 4 hours before your baby is born听and would normally听be听administered听intravenously through a cannula听in your hand every听4听hours throughout labour.听In addition:听
- if听your waters break (membranes rupture) prior to spontaneous labour you will be advised听to have labour induced (artificially started) as soon as possible,听as this is when the baby is at most risk of developing infection. Ask for our听鈥�Induction of Labour鈥�听leaflet for more information.听听
- you听are still eligible to use the bath for labour and birth听(unless you have other risk factors听or need a hormone drip as part of the induction process)听听
- your听baby will be closely monitored for signs听of infection after birth听
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If your waters break preterm (before 37 weeks) but you are not in labour, you may be offered a course of听oral听antibiotics.听See the National Institute of Health and Care Excellence (NICE) guidance NG25 on Preterm Labour and Birth:听听听
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For more in-depth information regarding GBS please听see 鈥�Group B Streptococcus in Pregnancy and Newborn Babies鈥� leaflet (RCOG,听听to read in听addition to this page. 听
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References听
Group B Streptococcal Disease, Early Onset (Green Top Guideline No.36).听听
Group B Streptococcus (GBS) in pregnancy and newborn babies. Information leaflet.听听
Group B Strep Support (GBSS) website:听听听
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National Institute of Health and Care Excellence (NICE) guidance NG25 on Preterm Labour and Birth:听听听