Please sign. (GBS testing petition) - Page 3

tracyb · #21 (**permalink**) 23-Nov-2007, 17:20

yes they do inform the women and of course they are given the usual lovely leaflet (if in doubt hand a leaflet out-you know how it is) they are not swabbed at delivery, thats why I said the timing I believe is inappropriate for the urine test, but I don't believe they would mix it up/get confused with a UTI instead of strep B, protocol is IV antibiotics in established labour (no guesses that multips don't always get this) even if the strepB was in the previous pregnancy.

wannabe · #22 (**permalink**) 23-Nov-2007, 18:04

But isn't the presence of GBS in the *urine* likely to indicate colonisation (not necessarily infection, so yes - technically, not UTI) in the urinary tract and not necessarily in the reproductive tract? If you want to test for the presence of GBS in the reproductive tract then why not test for the presence in the reproductive tract, rather than in the urine?

And of course, GBS is transient - so you're basically pumping all those women with IV antibiotics who aren't even GBS positive. 'Superbugs', anyone?

tracyb · #23 (**permalink**) 23-Nov-2007, 23:04

Did I say I made the rules? invented the protocols? No, and neither did I say I agree I'm merely sharing the information of what is done at the trust I am based at, thats all, just info sharing so others know some of the things that go on in other hospitals, and we can compare etc... I am not basically pumping these women with antibiotics, the trust has protocols-I'm merely a student not a directorate.

wannabe · #24 (**permalink**) 24-Nov-2007, 01:00

okay, I should have phrased that differently. As a result of the policy you describe - and leaving aside whether in-labour prophylactic IV antibiotics are appropriate for *all* GBS positive women - women who are not even GBS positive are being given IV antibiotics. The profligate use of antibiotics is a major contributor to the evolution of antibiotic resistance in bacteria (aka 'superbugs').

I still don't understand the thing about urine (as opposed to vag swab) testing. Is that the standard way to test for GBS in early pregnancy?

caroline · #25 (**permalink**) 02-Jan-2008, 14:38

I have just signed too.
xx

Annika · #26 (**permalink**) 20-Aug-2008, 15:58

I have signed this to x

june · #27 (**permalink**) 23-Aug-2008, 12:35

Originally Posted by IndieMidVic

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.

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....

Vicky hope you dont mind me cutting bits out of your wonderful post. I just wanted to comment on the bits I have left in.
Huge can of worms is exactly what it is.
IF I had been given full information about what GBS is, what would be the recommended treatment if I tested +ve in pregnancy and therefore what the implications would be (ie hospital birth) I would not have had the test. I did have the test, it came back +ve and the lovely NHS midwives then had their hands tied. They were no longer able to fully support my decision to have a HB (as I had had with baby #2) because I was 'going against policy' and the then HoM said 'putting my baby at risk'. I chose an IM and it was a wonderful decision for me but not all women can/ want to do that. Now pg with baby #4 I'm in the same situation - NHS mws will support me this time but we'll see. It is very frustrating as a student and as a mother!
IMO not only are booking clinics too busy to allow luxury of time to explain properly but the system is so paternalistic 'we know best' and then there's litigation to worry about.
Probably said too much now...........!

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