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Re: Group B Beta strept screeningFrom: Kathi Wilson, BHSc, RM (wilsonk@gtn.net)Sat Jan 29 17:08:07 2000
At Fri, 28 Jan 2000, Geffrey Klein, MD wrote: > >I don't think the CDC directly addressed this issue in the 1996 guidelines. >They did not list carriage in a prior pregnancy as an indication to treat. >However, you gotta admit that it would make a you a little nervous not to >treat a woman who was a carrier in a prior pregnancy.. There are false >negative cultures. Also, false positive cultures. Friend of my who once worked (as a masters student in physiology) in a high-level research lab locally in these parts said that they always had a terrible time in spring and early summer w/ bacterial contaminants in the lab, presumably due to the humid weather in these parts during that time. She told me that the only way that they could determine was to grow a control plate; if it cultured out something (with nothing put in *to* culture), then they knew they had a problem. When I was a student, we had a huge series of women come back GBS positive during the late spring; like *all* of them. When we approached the lab about this, they got real huffy and wouldn't talk to us. One of the women I swabbed in labour after her membranes ruptured (this was less than 3 weeks after her original swab, said to be pretty stable at this point) and, guess what? Yep, GBS -ve. We *are* probably treating women who aren't GBS +ve and never have been. The technology ain't perfect. Up here, we use risk-factor based treatment, because the best estimate is that only 10% of women are GBS +ve. Of our women who elect to swab (because we give them the choice), only a very few come back GBS +ve. I've also had women who've been GBS+ve in a previous pregnancy come back -ve in a subsequent pregnancy. It's a problem.
-- Kathi Wilson, BHSc, RM Thames Valley Midwives, London, Ontario, Canada mailto:wilsonk@gtn.net http://tvm.on.ca
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