Effect of Group B Streptococcus Infection on Perinatal Morbidity and Mortality
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 7
Abstract
To study effect of Group B Streptococcus (GBS) infection on perinatal morbidity and mortality. The study included 986 pregnant females at 35-37 wks of gestational age attending the antenatal outpatient department at tertiary care hospital in northeastern India. All participants were screened by conventional method of two rectovaginal swabs for GBS colonization in Blood Agar media and secondly with serum for antigen detection by rapid latex test for use in qualitative detection of antigen from GBS by Wellcogen Strep B kit. Data of neonates born to GBS positive mothers were divided into Group A (GBS present) and Group B (GBS absent). Patients of Group A were alternatively divided into control Group (C) and Test Group (T). Only the Test Group [T] were given intrapartum antibiotics [IAP] whenever they went into labor. Antibiotics policy followed was as per CDC guidelines; Inj ampicillin 02gm I.V. stat followed by 01gm I.V. q 6 hours till delivery of the patient. Records of the clinical rupture of the membranes, its duration and any clinical signs of chorioamnionitis were maintained. Specific clinical signs that indicate high risk for early onset neonatal sepsis (EONS) by GBS such as fever >100.4°F, foul smelling liquor or fetal tachycardia were documented. All the neonates born to GBS positive mother with symptoms of EONS were recorded. A total of 986 antenatal women were screened for GBS carrier state between 35-37 weeks of gestation and were followed till delivery. 162 women tested GBS positive by both methods [16.4%] [Group-A] and 824 tested GBS negative [83.6%] [Group-B]. Two infants out of 81 in control group were colonized by GBS against none in the test group, which was not significant [P >0.05]. There was one case each of EONS of non-GBS origin, both in control group and test group. Only one infant was admitted in neonatal intensive care unit [NICU] which was not statistically significant. There was no neonatal mortality in the study. Screening of high risk women for GBS vaginal colonization early in labor with rectovaginal swab culture and rapid antigen detection tests is equally effective. No recommendation regarding administration of intrapartum antibiotics can be made on the basis of this study. A larger multicentric study needs to be conducted to study the effect of intrapartum antibiotics on GBS colonization among neonates born to GBS positive mothers.
Authors and Affiliations
Col Vb Tripathi, Col V. Pavithra, Brig (Dr) Arun Tyagi, Brig (Dr) A. B. Khare
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