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Re: beta strep screeningFrom: Garry E. Siegel (garrys@atl.mindspring.com)Wed Nov 6 17:49:26 1996
At 12:24 PM 11/6/96 -0600, you wrote: >I am interested in what is happening in your practices regarding >screening for beta strep. In my community, the ob-gyns are completing >rectal/vaginal cultures between 35-37 weeks fairly consistently, >according to the June ACOG/CDC guidelines. The Family Practice groups >do not screen "low risk" women routinely. The 2 "options" for management of Group B strep screening are well explained in the CDC report of about June, 1996 (they have a website--use a search engine under "CDC" to find) or in the ACOG report of June, 1996 (I bet you can get this from http://www.acog.net, but I'm not sure). Briefly, the options are: 1. Screening all at 35 to 37 weeks, as you mentioned. All positives are treated in labor, regardless of risk (see below). 2. Not screening, but culturing and treating women in high risk situations for neonatal disease, ie ROM more than 18 hours, prematurity, or those whose previous infants have gotten ill. The family practice docs need to read these reports and do one or the other to be in line with the standard. Personally, people much smarter than I have evaluated multiple ways to handle this, and the big boys at ACOG/CDC/Am Assoc Peds have come up with these 2 choices. While it is up to us, as clinicians, to make decisions, whenever I enter into lengthy discussions with pregnant patients about the 2 options, they invariably want to test. Of course, they do not understand, as we do, the concerns about antibiotic exposure, resistance, cost, etc--but the "big boys" have already thunk on this one, so I'm culturing all of them. I would be happy to forward copies to you--if needed, please email privately.
-- Garry E. Siegel, M.D. garrys@mindspring.com
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