group B streptococcus delivery

No blood test, but self collection via SWAP. 'Group B streptococcus' is a bacterium that is present in the vagina (vulva) in many pregnant women. Usually this bacteria does not harm the pregnant woman and her baby, but in a few cases, the baby becomes seriously ill due to infection with this bacteria.

(Material eSwab)

Group B Streptococci are bacteria that are only visible under the microscope. There are several types of streptococci. Group B streptococci (GBS) is one of them.

GBS occurs in one in five adults without any symptoms. One in five pregnant women carry these bacteria; they are called carriers.

The GBS can be found in the intestines together with other bacteria. Often they can also be found in the cervix or vagina without any symptoms. Sometimes they cause a bladder infection. They can then be found in the urine.

How does GBS affect newborn babies?

About half of the women who carry these streptococci pass them on to their child during childbirth. One in five pregnant women (twenty percent) is a carrier.

This means that 10% of all newborn babies are infected with GBS. The bacteria are then only present on the skin or mucous membranes of the child.

The baby will NOT get sick from it.

Of all newborns, about one in a thousand becomes ill from a GBS infection. The bacteria then enter the body. The child can then become very seriously ill. Children of mothers who are carriers of GBS become ill in one in every hundred cases. This illness can usually be treated well with an antibiotic.

If a pregnant woman carries GBS, the child may be infected while in utero. Infection can also occur during labor or after birth. If a child is already infected with GBS in the womb, it usually happens after the rupture of the membranes. The streptococci enter the uterus from the vagina through the cervix and reach the unborn child. The child drinks amniotic fluid and also has amniotic fluid in the lungs. Thus, the baby can be infected and become ill even before birth. This chance is greater the longer the water has been broken. In exceptional situations, contamination and infection occur in the womb without the membranes being broken. Increase in temperature of the mother and rapid heartbeat of the baby are indications of infection.

If GBS is present in the vagina (vulva), about half of infants become infected during delivery. Usually the streptococci do not cause any symptoms of illness then. They only remain on the baby's skin and mucous membranes. In a few cases, about one percent, the baby does get sick, usually quite soon after birth. In less than a third of cases, the baby does not get sick until after the first week of life. This is then a GBS disease that develops late. Thus, children can still become ill in the first three months of life. Sometimes they are already infected during birth, but illness through the GBS bacteria only develops later.

In other cases, the child is infected after birth, for example via the hands of an adult. Even if a child does not become ill until later as a result of GBS, the course of the illness is often very serious.

When a newborn becomes ill due to an infection with Group B streptococcus, in nine out of ten cases it is on the first day. The child's breathing is often rapid and shallow. Sometimes breathing stops for a while. The colour of the skin is not nice and pink, but grey, blue or pale. The child may feel limp and drowsy. Sometimes the baby is overexcitable and convulses occur. Often a soft moaning sound during exhalation is the first symptom of illness. This moaning is an important warning signal, but rapid breathing or a different colour can also draw attention.

Feeding problems such as spitting up or not wanting to drink, fever or too low temperatures are sometimes also a sign of GBS disease.

When a baby becomes seriously ill from streptococcus bakcterie it is often a result of inflammation, such as pneumonia , a blood infection or meningitis. Sometimes several infections occur simultaneously. Meningitis is more often seen in children who become ill a little later after birth.

Symptoms of illness can develop very quickly, sometimes within hours. Therefore, medical help may arrive too late. Sometimes the course of the disease is so rapid and severe that even a quickly started treatment with an antibiotic cannot prevent a bad outcome.

A GBS infection tends to appear 'out of the blue'. There are no indications of an increased risk of this disease during pregnancy or childbirth. In a number of cases, it is known that the baby does run an increased risk of illness through a GBS infection:

• a premature birth (gestational age less than 37 weeks);
• prolonged broken membranes (more than 18 to 24 hours);
• increase in temperature of the mother during delivery (higher than 37.8-38.0 degrees Celsius);
• a bladder infection caused by GBS in the mother during pregnancy;
• a previous child with GBS disease.

Testing of every pregnant woman is not recommended in the Netherlands. After all, GBS is found in one in five pregnant women and only very rarely has any consequences.

However, in certain situations, it is wise to do research, such as with a pregnant woman who is admitted to hospital because of premature labour or a premature rupture of the water supply. The streptococci can then be detected using a culture. To do this, a nurse first strokes a cotton swab along the entrance to the vagina, and then along the anus.

Sometimes group B streptococci are detected in a woman before pregnancy/ This has no consequences for childbirth, as long as there are no other risk factors, such as preterm birth, fever during childbirth or prolonged rupture of membranes.

Read also Angela's personal story in Kek Mama

Takeaway instructions:

See instructions for taking the group B streptococcus test here

You will also find this information in the test kit.