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Re: OB: GBS and advanced dilatation From: Andrew Folley (agfolley@hotmail.com) Wed Sep 13 17:03:28 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Babycatchers@aol.com: "Re: quiet list" Previous message: Andrew Folley: "Re: epidural and food" In reply to: Garry E. Siegel, M.D.: "OB: GBS and advanced dilatation" Next in thread: Efrain Ramirez: "Re: OB: GBS and advanced dilatation" It would be nice to know how many full term babies that deliver within 1 to 2 hours of SROM have had any morbiidty from GBS. I would be close to "0" per year. Secondly two doses are not required one may be sufficient. Every hour after the frist dose the GBS coloiy count diminishes significantly approaching less than 3% colonizaion at 4 hours. In other words a baby born at 3.5 hours after penicillin probalby has the same morbidity risk as one born after the second dose. A pragmatic solution so alleviate her fears would be to either treat her now with oral penicillin and or have her take a one time dose of penicilliin at home at the onset of labor. Ie 1 gram pen-Vee po etc. No studies...... but it would make sense clinically. >From: garrys@mindspring.com (Garry E. Siegel, M.D.) >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: OB: GBS and advanced dilatation >Date: Wed, 13 Sep 2006 16:33:38 -0500 > >33 YO P2002, now at 37 weeks, has had 2 SVDs, the last of which was >quick--around 1-3 hours after hospital arrival. > >This pregnancy, she is GBS positive, having been negative the last two. > >She is 4-5 cm/50%, and very worried about GBS. > >We discussed the neonatal implications of delivering with no antibiotics >(i.e. she walks in and delivers rapidly), or what happens if she gets >only one versus two doses of Pencillin. Of course, I explained that the >attack rate is very low, and that even "full" dosing only prevents early >onset disease around 50% of the time. > >She is open to about anything, and we've made a plan, though I have just >thought of another option while typing that I previously didn't >consider. > >Any thoughts? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA _________________________________________________________________ Call friends with PC-to-PC calling -- FREE -- _________________________________________________________________ http://imagine-msn.com/messenger/launch80/default.aspx?locale=en-us&source=wlmailtagline Next message: Babycatchers@aol.com: "Re: quiet list" Previous message: Andrew Folley: "Re: epidural and food" In reply to: Garry E. Siegel, M.D.: "OB: GBS and advanced dilatation" Next in thread: Efrain Ramirez: "Re: OB: GBS and advanced dilatation"

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