-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: GBS From: Anna Meenan, MD (annam@uic.edu) Sat Aug 13 21:55:46 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: GBS" Previous message: Charlie Chambers: "Re: GBS" In reply to: Lorrie Stanley, CPM: "GBS" Next in thread: Garry E. Siegel, M.D.: "Re: GBS" Reply: Garry E. Siegel, M.D.: "Re: GBS" Welcome to the list, Lorrie, and thank you for introducing yourself. Not everyone is hostile to CPM's here. Just don't mention home delivery or you'll get El's pizza retort :-) You managed your sister-in-law very appropriately the first time (and my goodness you're brave. I would never take care of an in-law. Much too dangerous in my family). Like the rest of the guys, I can't believe she is refusing antibiotics the second time around, especially after spending 5 days watching her newborn struggle for life in the NICU. What exactly is she afraid of with antibiotics? I have been able to convince some folks who refuse things for their kids to change their minds by asking them to think ahead and imagine how they would feel in the event that there was a bad outcome, knowing that it was a direct result of their decision that it occurred. Treating everyone with IV antibiotics is not appropriate, and since the most recent CDC guidelines came out, it is no longer appropriate to skip testing and treat only based on risk factors. Everyone should be tested, except those who have had a previous affected infant, and those who grow GBS on a urine C&S at anytime during the pregnancy. Only when results are not available should treatment be based on risk factors (though our L&D nurses have decided that they will treat anyone who doesn't have a result on the chart). Best of luck to you in treating your SIL this time around. I agree with the guys. Document, document, document any refusal of care (and pray a lot). -- Anna Meenan, MD, FAAFP At Sat, 13 Aug 2005, Lorrie Stanley, CPM wrote: > >Hello, I am new here so will post an intro. I am a CPM (Certified >Professional Midwife) practicing in Tyler, Texas. No flamming please. >We are lisenced in the state of Texas. I am hoping to learn as much as >possible from you all experienced MDs and CNMs and hope to one day in >the future join the ranks as an OB/GYN as my children get old enough for >me to have the nerves and patience to go through medical school. > >GBS is a touchy subject and I would like to know what most of your >protocols are concerning testing/treating GBS if anyone is willing to >share this info with me. I know there are a large varieties of testing >and treating protocols and would like some ideas of standards in the >medical community. My protocol has been to test at 36 weeks; if >positive, offer treatment options of p.o. antibiotics til delivery or >IV during labor (except those refusing meds and then offer herbal >treatments). > >However, I did have my SIL as a patient of mine; tested at 36.4 weeks, >went in labor before results returned. SROM only 4-1/2 hours before >delivery, pushed 3 hours (took a while to get the "hang" of how to push >correctly). Apgar 9/10. About 2 hours postpartum, baby got severe >respiratory distress and tested positive for GBS. Was in NICU for 5 >days, 6 lb, male. Results for GBS came in after delivery, of course, >but were negative. Now she is expecting again and I know with prior >delivery of GBS+ baby, she is at higher risk for developing it again. My >advice is IV meds during labor, which she is opposed to. > >Any advice? I have heard that some are treating every mom >prophylactically with IV during labor and my backup only tests/treats >those with risk factors. What are your protocols and what treatment >options would you give the G2P1 with prior GBS+ baby? > >-- >Lorrie Stanley, CPM > Next message: Garry E. Siegel, M.D.: "Re: GBS" Previous message: Charlie Chambers: "Re: GBS" In reply to: Lorrie Stanley, CPM: "GBS" Next in thread: Garry E. Siegel, M.D.: "Re: GBS" Reply: Garry E. Siegel, M.D.: "Re: GBS"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:40:42 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.