Do during pregnancy
At first antenatal visit
- Check file notes
- Ask woman if baby infected with GBS in previous pregnancy or if GBS detected in current
pregnancy
If GBS positive urine anytime during pregnancy
- Must treat immediately — give amoxicillin oral — adult 500mg, 3 times a day (tds) for 5 days
- If allergy to penicillin — medical consult
- See — Urine infections in pregnancy for follow-up
- Will need antibiotics in labour if GBS positive urine at any point in pregnancy even
if previously treated
GBS swab — 35-37 weeks pregnant
- Take combined vaginal (first) and anal swab (second) at 35–37 weeks pregnancy — can
be self-collected by woman
- If swab GBS positive
- Record in file notes
- No antenatal treatment needed
- Explain meaning of positive result — will need antibiotics in labour
- Advise woman to report signs of labour or rupture of membranes early so antibiotics
can be started before baby is born
Do in labour
If woman GBS positive at any time during pregnancy
- Plan for birth in hospital
- If not possible to send to hospital before birth
- Give antibiotics
- Transfer mother and baby after birth
- See Newborn care
Treat for GBS
- Woman with GBS positive swab or urine in this pregnancy
- Woman with previous baby infected with GBS
- If GBS status unknown or no GBS swab in last 5 weeks — give antibiotics if
- Preterm labour
- Premature rupture of membranes (37 or more weeks pregnant)
- Prolonged rupture of membranes — more than 18 hours or unknown time since membranes
ruptured
- Give benzylpenicillin IV — adult 3g, single dose straight away
- THEN benzylpenicillin IV — adult 1.8g, every 4 hours until birth
- If allergy to penicillin — medical consult
- Stop treatment immediately after birth