Streptococcus in pregnancy - what it is, how it occurs, symptoms and treatment
At the end of pregnancy, every pregnant woman is cultured (swab) from the vagina and anus to detect the presence of streptococcus. A microorganism called Streptococcus agalactiae is a type of bacteria commonly found in the digestive tract (intestines) and genitals. It is usually harmless in healthy adults, but in pregnant women group B streptococcus can cause urinary tract infections, infection of the placenta and amniotic fluid, inflammation and infection of the lining of the uterus (endometritis), infection of the bloodstream (sepsis).
Author:Jennifer Smith
Updated: 04.12.2023
Streptococcus is found in the vagina of many healthy women (estimated between 10 and 35% of women). During childbirth, it can be transferred to the child (1 in 200 children) and cause infection. When is streptococcus in pregnancy harmless and when is it a problem? How to eliminate the risk?
What is streptococcus in pregnancy?
Every pregnant woman should undergo an examination for the presence of streptococcus in the vagina at the 36th week of pregnancy. The result of the examination is either GBS positive or GBS negative - that is, the presence of group B streptococcus (Group B Streptococcus) is confirmed. In general, streptococcus is not harmful, it does not cause problems for the woman, but during childbirth, the fetus can become infected by passing through the birth canal.
In the 36th week, vaginal material is taken from the mother-to-be for culture, a swab is also taken from the anus. If the test is positive and the woman has no problems, she is not treated immediately, if she has problems and streptococcus is found in the urine, immediate treatment is necessary.
A woman may not know about streptococcus at all, because it may not cause any problems. In about a third of adults it is present in the intestinal tract, in a quarter of women its presence is common in the vagina. Streptococcus may or may not be harmful, it may or may not cause complications for all newborns. Those who become infected are at risk of meningitis, pneumonia or blood poisoning, which often end in death.
Positive streptococcus in pregnancy
If the mother is infected, the newborn is also at risk. Symptoms of the disease can appear within a few hours after birth. The infection manifests itself as pneumonia, brain inflammation, blood poisoning with bacteria (sepsis). Exceptionally, the condition is so serious that the lungs and important organs fail. In the case of a less massive infection, the infection develops gradually and the child is cured with antibiotic treatment. The risk of the disease and the occurrence of severe forms of the disease is reduced precisely by the examination of the woman and her treatment.
In the case of the confirmed presence of streptococcus in the vagina, a woman is given intravenous antibiotics through an infusion, which also reach the blood of the fetus, and it is protected from infection by about 80% during childbirth. During pregnancy, the fetus is protected by a sac membrane, so the bacterium does not threaten it. There is also a risk with caesarean section, so it is not a 100 percent solution to avoid streptococcal infection.
Streptococcus in pregnancy - the cause
Streptococci are anaerobic microorganisms of spherical shape, which are divided into many groups. Group B streptococcus is dangerous and can cause dangerous infections in adults with certain chronic diseases (liver diseases, diabetes), but the reason why some groups are more at risk is not known. Transmission of streptococcus is possible through droplets, kissing, sexual intercourse or through infected objects. Group B streptococci are a common part of the body, 20-40 percent of the adult population have them in the intestinal tract, 3% of men have them in the urethra, and approximately 25% of women have them in the vagina. In some people, they appear in the body for a short time, in others they last a lifetime.
The increased risk of streptococcal infection in adults is in the case of diseases that damage the immune system. What causes streptococcus in pregnancy? Expectant mothers with diabetes, those who have overcome cancer or liver disease belong to the endangered group. This means that there is a high risk that they already have streptococcus in their body. Infection in a pregnant woman can occur from her own digestive tract, or by transmission to the genitals during sexual intercourse. The risk of infection for the unborn child increases if group B streptococci bacteria have been detected in the urine of a pregnant woman (bacteriuria), if the mother has overcome an infection of the placental tissues and amniotic fluid or her amniotic fluid has flowed prematurely. Then, antibiotics are automatically applied after detection of beta-hemolytic (β-hemolytic) streptococcus in pregnancy.
Streptococcus in pregnancy - symptoms
In most cases, streptococcus does not manifest itself. A pregnant woman is most likely unaware of its presence. However, if the infection breaks out in adulthood, group B streptococci can cause urinary tract infections, blood infections (bacteremia) and pneumonia. However, it most often affects the intestines, vagina, anus, bladder or throat.
Streptococcus in a newborn - symptoms
Children born to a mother positive for these microorganisms may not automatically suffer from streptococcus. If the child becomes infected, the infection may have an early or late onset. With early onset, symptoms appear within a week after birth, with gradual onset, the interval can be from 1 week to several months. At the early onset of infection, streptococcal manifests itself as high or low temperature, difficulty breathing and wheezing, lethargy, problems with food intake or changes in skin color. With late onset, symptoms such as temperature, difficulty breathing, lethargy and irritability, complications with swallowing appear.
Affected newborns are at greater risk of death or irreversible/irreversible disability, such as damage to sight, hearing, mental retardation. Predominantly immature and immunologically affected fetuses are burdened with a higher risk of suffering from streptococcal sepsis with fatal consequences.
Treatment with antibiotics
Unless it is a premature outflow of amniotic fluid, streptococci are treated only just before or during childbirth. In case of earlier treatment, repeated infection often occurs. The presence of microorganisms is verified approximately 4 weeks before the proper birth. In spontaneous labor, antibiotics are administered just before or during labor, which reduces the risk of transmission to the fetus. Group B strep is usually treated with penicillin, to which 1 in 10 mothers have a mild allergic reaction (skin rash), and 1 in 10,000 mothers have a severe allergic reaction.
In the case of amniotic fluid drainage (12+ hours), even a woman who does not have confirmed group B streptococcus in the vagina receives antibiotics. This is a matter of prevention, because the bacteria can be transferred from the anus to the vagina and through the damaged amniotic sac to the fetus.
Both the obstetrician and the pediatrician must be informed about the occurrence of β-hemolytic streptococcus, so that they can intervene adequately in case of infection of the newborn.
Streptococcus in pregnancy - experience
According to forums and discussions, many mothers-to-be were diagnosed with streptococcus from culture and given antibiotics before and during delivery. For some babies, it was a disappointment, because water birth is not possible with streptococcus. As they said, streptococci occurs normally in the vagina and anus, it is not a risk for the mother, only for the child at the time of birth, that is why a swab is taken. Thanks to antibiotics, the risk of infection of the newborn is very low. It is important to come to the maternity hospital early so that there is enough time for ATB application.
The most frequent questions - FAQ
Streptococcus in pregnancy is quite common, but usually does not threaten the mother. The risk for the child only arises at the time of birth, otherwise it is protected from the microorganism by the sac of membrane. In the article, we told you all the important information about the causes and symptoms of streptococcus. Are you interested in anything else? Do you want to share your experience with streptococcus in pregnancy? Comments are available below the article.
When can streptococci attack during pregnancy?
What should I do if I am allergic to penicillin?
What is prevention in pregnancy?
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