Intrapartum penicillin prophylaxis
Intrapartum penicillin prophylaxis refers to the administration of penicillin antibiotics to women during labor and delivery to prevent the transmission of Group B Streptococcus (GBS) infection to their newborn infants. Group B Streptococcus is a type of bacteria commonly found in the gastrointestinal and genital tracts of healthy adults but can cause serious infections in newborns, including sepsis, pneumonia, and meningitis.
Here’s how intrapartum penicillin prophylaxis is typically implemented:
- Screening: Pregnant women are typically screened for GBS colonization between 35 to 37 weeks of gestation. This involves a swab of the vaginal and rectal areas to detect the presence of GBS bacteria. Women who test positive for GBS colonization are considered carriers.
- Identification of Risk Factors: In some cases, women who have previously had a baby with GBS disease, have GBS bacteriuria during the current pregnancy, or who have a fever during labor may be considered at increased risk for transmitting GBS to their infants, and intrapartum antibiotic prophylaxis may be recommended even if they did not undergo GBS screening.
- Administration of Antibiotics: For women who are carriers of GBS or who have other risk factors, intrapartum penicillin prophylaxis is typically administered during labor and delivery. Penicillin is the preferred antibiotic for prophylaxis, although alternatives such as ampicillin or cefazolin may be used in women with penicillin allergies.
- Timing and Dosage: Intrapartum antibiotics are usually given intravenously to the mother at least four hours before delivery, although they can still be beneficial if given later. The dosage and duration of antibiotic treatment may vary depending on clinical factors and guidelines provided by healthcare organizations.
- Monitoring: Healthcare providers monitor the mother and newborn closely for signs of infection during labor and after delivery. Newborns born to mothers who received intrapartum penicillin prophylaxis are typically observed for at least 48 hours for signs of early-onset GBS infection.
Intrapartum penicillin prophylaxis has been shown to significantly reduce the incidence of early-onset GBS disease in newborns when administered appropriately to carriers during labor and delivery. It is an important measure for preventing potentially life-threatening infections in newborns.