Intrapartum Group B Streptococcus (GBS) prophylaxis is recommended for pregnant women under certain circumstances to reduce the risk of transmitting GBS to their newborn infants during childbirth. The indications for intrapartum GBS prophylaxis include:
- Positive GBS Screening: Pregnant women who have been screened for GBS colonization between 35 to 37 weeks of gestation and test positive for GBS colonization should receive intrapartum antibiotic prophylaxis. This involves taking vaginal and rectal swabs to detect the presence of GBS bacteria.
- Previous Infant with Early-Onset GBS Disease: Women who have previously given birth to an infant with early-onset GBS disease (within the first week of life) should receive intrapartum antibiotic prophylaxis during subsequent pregnancies, regardless of their GBS colonization status during the current pregnancy.
- GBS Bacteriuria during Current Pregnancy: Pregnant women who have GBS bacteriuria (presence of GBS bacteria in the urine) at any time during the current pregnancy, regardless of GBS screening results, are considered at increased risk for transmitting GBS to their newborn infants and should receive intrapartum antibiotic prophylaxis.
- Intrapartum Fever: Women who develop a fever (temperature of 100.4°F or higher) during labor are considered at increased risk for transmitting GBS to their infants, even if GBS screening results are negative. Intrapartum antibiotic prophylaxis should be administered in these cases.
- Unknown GBS Status with Risk Factors: In cases where a pregnant woman’s GBS colonization status is unknown and she has other risk factors for transmitting GBS to her infant (such as preterm labor, rupture of membranes for 18 hours or more, or preterm premature rupture of membranes), intrapartum antibiotic prophylaxis is recommended.
- Preterm Premature Rupture of Membranes (PPROM): In cases of preterm premature rupture of membranes (rupture of membranes before 37 weeks of gestation), intrapartum antibiotic prophylaxis is recommended to reduce the risk of GBS-related complications in the newborn.
These indications are based on guidelines provided by professional medical organizations, such as the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC). Intrapartum antibiotic prophylaxis helps reduce the risk of early-onset GBS disease in newborns and is an important aspect of prenatal care for women at risk of transmitting GBS to their infants during childbirth.