Group B strep prevention

Published on: 17/02/2016

Key areas for improvement in the prevention of Group B streptococcal (GBS) disease have been identified by a new RCOG audit.

Group B strep are bacteria found normally in the intestine, vagina and rectal area in around 25% of all healthy women.  Group B strep infections can affect both neonates and adults. Most pregnant women who are colonized by the bacteria have no symptoms. The infection can be spread to infants both before or during delivery.

The audit examined the current practice in preventing early-onset neonatal GBS disease, focusing on the care provided my Midwifery Led Units (MLU), local guidelines in obstetric units and patient information.The RCOG conducted the audit across 89 of the estimated 175 units in the UK.

 

Some of the key findings were that:

Nearly 40% of the participating MLUs accepted women in labour for delivery with confirmed GBS colonisation in her current pregnancy, but fewer units accepted women with other risk factors for GBS (for example other medical conditions that impair your immune system, such as diabetes, HIV infection, cancer or liver disease).

Reported practice on whether women with current GBS colonisation were accepted for delivery did not always reflect the admissions policy and the decision was made on a case by case basis.

Appropriate antibiotics were available at 90% of the units where women were accepted.

On reviewing local guidelines for 123 obstetric units, only a third of units showed evidence of regular review. Contrary to the national guidelines.

Information leaflets made available to pregnant women found that most of the information was consistent in describing risk factors, signs, symptoms and detection of GBS in pregnancy, however the leaflets were not easy to understand.

 

The audit concluded by making a number of recommendations. These included revision of the national guidelines to reflect the findings from the audit and a review of local protocols to take place every three years to ensure they are fit for purpose and reflect national guidance.

It recommended that admission criteria and practice in MLUS should be informed by national guidelines. It also said that a nationally produced patient information leaflet should be used by all NHS trusts.

 

For mor information on the audit see he RCOG summary here

Or the RCM article on the topic here