Hi All
The current GBS testing isn't reliable at all on the NHS as it has a very high false positive; It picks up on women who carry inactive GBS which carries no risk. Also, this test is done very early on in pregnancy and as we know, GBS can go through phases of active and inactive throughout the pregnancy and therefore a result given in the second trimester is a waste of time.
The best option for women who
choose to have a test for GBS is the Enriched Culture Method (ECM) test. This is usually done around 36-37 weeks, is a vaginal and rectal swab and can be done by the woman herself. It is the most reliable test for women to establish if they have a active phase of GBS and as it's done so late, there is a good chance that a neg result will remain so until babe is born and a pos result will stay pos etc...
As for actually doing the test, I tend to take a very cautious stand on this as it opens a huge can of worms and as an independent I then have a fight on my hands to keep women at home with consultants on my back!
The research isn't conclusive on the benefits of giving prophylactic antibiotics in labour in women with GBS as there have been cases where babies have contracted GBS and then septicaemia even when mum has had antibiotics. There is also contradictory advice on method of admission of ab's. Most units use the IV method but some are using oral ab's.
Basically, if a woman has had a pos GBS result in the past, I discuss the subject thoroughly, give her all of the current research and give her the option to have the ECM test, but don't recommend it. If she goes for it, I counsel her on the possible results so she knows what she's getting herself into, then we have the problem of ab's in labour...is she going to have them or take a watch and wait approach?
If a woman hasn't had a positive result in the past, I don't even bring it up if she doesn't mention it as it isn't relevant to her.
With all of my women, I discuss normal behaviour in a newborn baby and abnormal, so if she sees anything weird, she will usually let me know straight away..so if a baby becomes ill following delivery, we are usually all over it and jump into action, so if a woman had undiagnosed GBS we are looking for symptoms in the baby anyway.
Annnywaaayy... following my rather long post ~(sorry), I won't be signing this petition as the NHS will not discuss the implications of testing with women and will probably abuse any testing available as they will not properly prepare women for a positive result. As the research on treatment of GBS is still in discussion, it seems a waste of time to push further testing until we have a good, research based management programme.
I'm not NHS bashing here, but there are so many other tests performed 'routinely' and women do not understand the testing and most are told it's routine and not a choice. An example of this is the HIV/Syphillis/Hep B test. Women opt into these tests without being properly counselled beforehand on the possibility of a positive result and when they get a positive, it's a massive shock as they didn't fully appreciate the implications of their agreeing to the 'routine' booking blood test in the first place. Our booking clinics are so busy, it's like a production line and I personally cannot see midwives being given more time to properly explain GBS testing and it's implications etc....
I could go on...but I won't!
Vicky xx