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Group B Streptococcus (GBS) Screening in Pregnancy

Universal vaginal-rectal culture at 36-37 weeks and intrapartum antibiotic prophylaxis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Group B Streptococcus (GBS) Screening in Pregnancy?

Group B Streptococcus is a Gram-positive coccus that colonises the rectum and vagina of 10-30% of healthy women without causing maternal symptoms.

Vertical transmission during labour or delivery causes early-onset (under 7 days) neonatal disease in 1-2% of colonised mothers without prophylaxis, with 4-6% case fatality.

Universal antenatal vaginal-rectal screening at 36 0/7 to 37 6/7 weeks is recommended by international guidelines (ACOG, CDC, RCOG).

Symptoms

Maternal: usually asymptomatic colonisation; rarely urinary tract infection, chorioamnionitis or postpartum endometritis
Neonatal early-onset disease (under 7 days, usually within 24 hours): sepsis, pneumonia, meningitis
Neonatal late-onset disease (7-90 days): bacteraemia, meningitis, focal infections (cellulitis, septic arthritis, osteomyelitis)
Risk indicators in labour: maternal fever over 38°C, prolonged rupture of membranes (over 18 hours), preterm labour under 37 weeks
Previous infant with invasive GBS disease
GBS bacteriuria in current pregnancy
Unknown GBS status with risk factors (preterm, prolonged membrane rupture or fever in labour)

Risk Factors

Maternal GBS rectovaginal colonisation
Previous infant with invasive GBS disease (regardless of current status)
GBS bacteriuria during current pregnancy (treat infection and give intrapartum prophylaxis)
Preterm labour under 37 weeks with unknown GBS status
Prolonged rupture of membranes (over 18 hours)
Intrapartum maternal temperature over 38°C
African American ethnicity has higher colonisation rates
Diabetes mellitus and obesity may modestly increase colonisation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • All pregnant women should receive universal antenatal screening at 36 0/7 to 37 6/7 weeks
  • Patients with previous GBS-affected infant or current GBS bacteriuria need intrapartum prophylaxis without screening
  • Preterm labour, preterm prolonged membrane rupture or fever in labour with unknown GBS status warrants empirical prophylaxis
  • Penicillin allergy must be documented and severity assessed before delivery for antibiotic selection
  • Newborn evaluation needed if intrapartum prophylaxis was inadequate or risk factors present

Treatment Methods

01
Universal antenatal screening: combined vaginal-rectal swab at 36 0/7 to 37 6/7 weeks; sample is valid for 5 weeks
02
Indications for intrapartum antibiotic prophylaxis: positive GBS culture, GBS bacteriuria in current pregnancy, previous GBS-affected infant, unknown status with intrapartum risk factors
03
First-line: penicillin G 5 million units IV initial dose, then 2.5-3 million units every 4 hours until delivery
04
Alternative: ampicillin 2 g IV initial, then 1 g every 4 hours until delivery
05
Penicillin-allergic, low risk of anaphylaxis: cefazolin 2 g IV initial, then 1 g every 8 hours
06
Penicillin-allergic, high risk of anaphylaxis with susceptible isolate: clindamycin 900 mg IV every 8 hours; if resistant, vancomycin 20 mg/kg every 8 hours (max 2 g per dose)
07
Adequate prophylaxis defined as appropriate antibiotic at least 4 hours before delivery
08
Newborn observation per neonatal sepsis risk algorithm; investigate and treat if symptomatic

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.