Detected by the so-called cotton swab examination, the presence of this bacterium in the mother’s vaginal canal is not synonymous with caesarean section. Here, everything a pregnant woman needs to know about group B strep
Strep B is a type of bacterium common in the vaginal and perianal region of women. Harmless to adults, it can be a risk to children during pregnancy. Dangerous to the point that the World Health Organization (WHO) published a survey calling for the urgency in developing and approving vaccines that can prevent contamination.
According to the WHO, infection rates with this bacterium are related to over 500,000 cases of premature births annually and lead to over 100,000 newborn deaths and at least 46,000 cases of stillbirth, as well as other long-term sequelae. Many doctors require the so-called cotton ball examination in the final stage of pregnancy, precisely to detect the presence or absence of streptococcus, as this can affect – but not always prevent – normal delivery.
But what are the risks, what is the relationship between bacteria and normal birth, and how can you protect your baby? We talked to the obstetrician and gynecologist Alexandre Pupo, from the Sírio Libanês hospital and the Albert Einstein hospital (SP), to understand.
Streptococcus B: what are the risks in pregnancy and childbirth?
“Streptococcus B is a bacterium that naturally colonizes the region of the anus, rectum and vagina. It lives with the flora without causing any damage. The problem is when it enters the cervical canal and infects the amniotic sac,” explains Pupo. It causes an inflammation called chorioamnionitis, which weakens the pouch and can lead to a rupture. The consequence can be a premature birth.
And the risks don’t stop there. “When the bursa ruptures, this bacterium can pass to the baby and colonize the lung, leading to neonatal pneumonia. More rarely, it leads to meningitis and septicemia (an infection that spreads rapidly through the body) and death,” he says.
Being a bacterium belonging to the human flora, the organism does not have an adequate defense. “This makes treatment with antibiotics very difficult. Therefore, contamination is a major cause of death in newborns and premature births,” the doctor points out.
Positive strep = zero chance of vaginal delivery?
What happens if the woman tests positive for Strep B at the end of her pregnancy? Can vaginal delivery be dangerous, due to the risk of the baby coming into contact with bacteria during the passage? Not necessarily. “First, of course, we do the research. If it’s positive, there are antibiotics to prevent the bacteria from reaching the fetus,” explains Pupo.
“Pregnant women with B-positive strep shouldn’t wait too long at home. They should go to the hospital or maternity ward a little earlier so they can be evaluated. If labor is indeed ongoing, the doctor should start the antibiotic regimen, “he adds.
According to the obstetrician, when the pregnant woman is positive for Strep B during labor, the fewer manipulations, the better. So no excessive tactile examinations, manual detachment of the bag or similar maneuvers. “If it is necessary to artificially rupture the bursa, it is necessary to wait for the second dose of antibiotic to be administered,” she points out.
Swab examination: when is it done?
To detect the presence or absence of the Strep B bacterium, healthcare professionals usually require the test, popularly called the swab exam, between the 35th and 37th week of pregnancy. “A swab is taken, as if it were a cotton swab, of vaginal secretion and another from the perianal region. Then a culture is carried out to find out whether or not there is the presence of colonization by this bacterium”, explains Pupo.
The examination is usually requested by most of the doctors in the private network, but there is controversy. Different medical associations from different countries recommend the test for all pregnant women. In the Brazilian public network, in some locations, it is required only for those with risk factors. This can happen when the water breaks before labor or when the pregnant woman has a fever. “Both features can be signs of chorioamnionitis, the infection of the water sac,” says the midwife.
How is the treatment for strep throat?
What if the strep B positive woman goes into labor or her water breaks? Antibiotic treatment is started during labor.
“This antibiotic is given intravenously to the mother (in a vein). The antibiotic then circulates through the maternal blood and ends up crossing the placental barrier. There, it will gain space for the amniotic fluid and reach the baby. Adequate concentration in the fluid. , the drug will prevent bacteria from colonizing the region, so it won’t be able to reach the fetus, “says the doctor.
“This should be done with a first dose of attack at least 4 hours before delivery. Then the woman should be given a dose every four to six hours, until the baby is born,” he adds.
Can Strep B be prevented?
Since the strep bacteria B is part of the gut flora, there is no way to prevent it. “She is or is not present and there is no point in treating her except during labor,” Pupo emphasizes. This is because, if the mother takes the antibiotic early, she disappears, but as soon as the drug is stopped, she will come back. “The strategy of treating bacteria outside of childbirth should only be reserved for those who are at imminent risk of infection. This needs to be carefully considered by the accompanying healthcare professional,” says the midwife. “Generally, it’s not recommended. Starting treatments early can make bacteria resistant to antibiotics,” she adds.
Are you getting to this stage of your pregnancy and your doctor hasn’t said anything about the Strep B test? Raise the issue and see if it recommends taking the test. All for the health of your baby.
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Source: Terra
Benjamin Smith is a fashion journalist and author at Gossipify, known for his coverage of the latest fashion trends and industry insights. He writes about clothing, shoes, accessories, and runway shows, providing in-depth analysis and unique perspectives. He’s respected for his ability to spot emerging designers and trends, and for providing practical fashion advice to readers.
