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Re: new GBS protocols???From: CNMMOM@aol.comFri Dec 1 17:58:41 1995
Gail, In our out of hospital birth center, we no longer screen prenatally. We prophylax any woman who has had a baby with GBS in a previous pregnancy once she is in active labor,and continue q 6h until delivery. We also prophylax anyone who has ruptured membranes 18 hours without delivery, and continue q 6h until delivery, though by Tx Department of Health we have to transfer at 24 hours post admission (not post rupture, if she didn't come in right away; the exception being immediately if infection is suspected). Although the Peds seem to like the prenatal screening, obstetrically it doesn't make much sense if you are going to prophylax them in labor anyway. We also prophylax with GBS in the urine in pregnancy. We prophylax with Ampicillin 2 grams initially and follow with one gram q 6h. The Peds tell us it makes no difference to them in terms of possibly obscuring newborn cultures, because if they suspect GBS they will treat regardless of the mother's status IP. For some reason, we have a phenomenally low rate of GBS in the Rio Grande Valley of Texas (tho Lord knows we have plenty of other problems) I thought these recommendations came from ACOG, not CDC. Cheers, Elizabeth Davidson, CNM
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