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Re: Group B Beta strept screening From: Cheri Van Hoover (cherivh@earthlink.net) Fri Jan 28 15:16:51 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jim Connerth: "Re: Estrogen Mask" Previous message: Cheri Van Hoover: "Re: Group B Beta strept screening" Maybe in reply to: Lily Kay CNM: "Group B Beta strept screening" Next in thread: Jomyrwhipt@aol.com: "Re: Group B Beta strept screening" Efrain Ramirez wrote: > How many of the listmembers have had anaphylactic reactions to > antibiotics in labor? >From CDC's MMWR Vol. 45 / No. RR-7, 1996: "Administering intrapartum antimicrobial agents to all women who are GBS carriers [in the U.S] could result in approximately 10 deaths per year from anaphylaxis, assuming a GBS colonization rate of 25%, 4 million deliveries in the United States annually, and a rate of fatal anaphylaxis to penicillin of 0.001% (69). Another 0.7%-10% of women to whom prophylaxis is administered is expected to have less severe reactions. (70). Severe complications can occur in the fetus even when maternal anaphylaxis is not life threatening (71)."(pg.9) The above references are: 69. Schwartz B, Jackson L. Invasive group B sreptococcal disease in adults. JAMA 1991;266:3284 70. Goodman LS, Gilman A, Gilman AG, eds. Goodman and Gilman's the pharmacologic basis of therapeutics. 8th ed. New York: Pergamon Press, 1990. 71. Heim K, Alge A, Marth C. Anaphylactic reaction to ampicillin and severe complication in the fetus. Lancet 1991;337:859-60. > How many of the list members have had babies with > severe neonatal sepsis/deaths because of GBS? Yes, I've seen the same tragic consequences of this disease as you have. Please don't think that I'm minimizing your concerns or doubting your experience. I am most certainly not cavalier about the risk of GBS disease. It's because I have had babies die and suffer life-threatening illness that I've made a point of reading extensively in the literature and trying to understand the best way to deal with this scourge. I don't think we've found it yet, but I do have concerns about enterococcal sepsis in the newborn and maternal anaphylaxis. > but it better be a > good data to show me that I am harming patients. At least must be > better than " 1) the natural history of colonization shows that although > 25% of people are colonized at any given time, it's *not* the same 25% - > colonization comes and goes; " yeah--sure--umjú. This research has been done. The reference I have is: Yow MD, Leeds LJ, Mason EO, Clark DJ, Beachler CW. The natural history of group B streptococcal colonization in the pregnant woman and her offspring. I. Colonization studies. Am J Obstet Gynecol 1980; 137; 34-8. I think the most interesting thing to come out of the CDC report is the information that several studies have suggested that the susceptibility to neonatal GBS disease is caused by a deficiency of maternal anticapsular antibody. I wish work on the vaccines mentioned in MMWR as being under development were ready now. I would encourage you to look at the article by Benitz that I posted yesterday. It's available in its full-text version at the URL in the reference. He's really done a remarkable work of scholarship on this project. Very impressive. -- Cheri Van Hoover, CNM San Francisco, CA Next message: Jim Connerth: "Re: Estrogen Mask" Previous message: Cheri Van Hoover: "Re: Group B Beta strept screening" Maybe in reply to: Lily Kay CNM: "Group B Beta strept screening" Next in thread: Jomyrwhipt@aol.com: "Re: Group B Beta strept screening"

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