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16 Cards in this Set
- Front
- Back
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Which expectant women should be screened for GBS carriage during pregnancy?
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All of them!
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At what time should GBS screening of pregnant women occur?
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Between 35-37 weeks gestation
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What cultures should be obtained when screening pregnant women for GBS colinization?
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Rectal and Vaginal swabs.
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Is a positive urine culture for GBS significant?
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Yes, the mom should be treated as if GBS positive.
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What special treatment should GBS positive mom's receive during labor?
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IV antibiotics (Ampicillin is the preferred agent)
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What is considered adequate maternal treatment of a GBS positive mom during labor?
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Receiving IV Ampicillin (or alternate if PCN allergic) at least 4 hours before delivery.
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If a mom had a previous pregnancy where SHE tested positive for GBS, but the baby did fine, what should you do this pregnancy?
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Screen her again and treat her like any other mom.
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If a mom had a previous pregnancy where the baby had GBS sepsis or meningitis what should you do?
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Treat that mom like she is GBS positive this pregnancy NO MATTER WHAT.
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If a mom comes in in labor, at term, and her GBS was either never done or not available, what should you do?
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As long as the baby is term (>37 weeks, maternal temp <100.4 and rupture of membranes <18 hours), the guidelines do not support using intrapartum antibiotics.
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How should a baby born to a GBS unknown mom be managed?
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This is more controversial... Dr. W recommendation would be to treat as an inadequately treated (<4 hours before delivery) GBS positive mom... screen the baby with CBC and Blood culture and observe x 48h.
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A 35 week baby is born clinically well to a mom who is GBS positive but had 2 doses of antibiotics 10 and 4 hours before delivery. How should you manage this baby?
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Screening CBC and Blood culture and observe closely for a minimum of 48 hours. ( the mom was treated adequately but prematurity is an indication for the screening w/u)
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A 40 week baby is born to a GBS positive mom who delivered precipitously and received 1 dose of Ampicillin 1 hour before delivery. The baby is born and with an hour or two is grunting, tachypneic, pale and generally lethargic.
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Full sepsis work up including CBC, BC, CXR (because of the grunting), LP (if judged stable enough to tolerate it) and empiric IV amp/gent.
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A 38 week baby is born to a GBS positive mom who received one dose of IV Ampicillin 8 hours before delivery. The baby is totally well. What should you do?
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No work up needed. Observe the baby for 48 hours. ( this was adequate treatment)
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A 39 week baby is born to a GBS positive mom who received 1 dose of Ampicillin 2 hours before delivery. The baby is totally well. What should you do?
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Screening CBC and blood culture and observe for 48 hours. ( this was inadequate treatment)
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What is a normal screening CBC?
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Generally speaking a normal CBC for a newborn has a WBC count of 9-34K, Plts >150 and and I/T ratio of <0.2
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A GBS positive mom has a term baby, the mom received 3 doses of IV Ampicillin (all >4 hours before delivery) and the baby remained totally well for the 48 hour hospital stay. What special advice should you give to this mom?
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Intrapartum prophylaxis only prevents early onset (<7 days of age) disease... late onset disease is still possible and mom should notify you immediately if the baby had a temp> or equal to 100.4, lethargy, poor feeding or other unusual symptoms.
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