(Video uploaded 01/2015)

Transcript

Title：How to prevent Group B Streptococcus (GBS) infection in newborns

Presenter: Dear expectant mothers, the following video clip will introduce information on how to prevent Group B Streptococcus (GBS) infection in newborns. Please listen carefully.

Expectant Mother: Nurse, what is GBS?

Nurse: GBS is a bacterium commonly colonised in the human intestines as well as the urinary and reproductive systems. It is not a sexually transmitted disease! About 10 to 30% of pregnant women are colonised with GBS in the vagina or rectum.

Expectant Mother: How does GBS affect pregnant women?

Nurse: Most pregnant women who are infected with GBS have no symptoms. A small number of pregnant women may develop urinary tract infections.

Expectant Mother: So, how does GBS infection affect the newborns?

Nurse: Actually, GBS is the most common cause of severe infection in newborns. This is because a woman colonised with GBS can pass the bacteria to her baby late in her pregnancy. About one out of every 100 to 200 pregnant women carrying GBS will give rise to GBS infection in the newborn. GBS infection can be classified as early- or late-onset.

Expectant Mother: What is early-onset GBS infection?

Nurse: In early-onset GBS infection, the following signs and symptoms usually occur within several hours or days after birth: Breathing problems; unstable heart rate and blood pressure; Lung infection; blood infection and meningitis are the most common presentations. Gastrointestinal and kidney problems can also occur. In Hong Kong, the incidence of early-onset GBS infection is around 1 per 1000 births. Early-onset GBS infection causes serious illness with a death rate of around 5 to 10%.

Expectant Mother: What is late-onset GBS infection?

Nurse: In late-onset GBS infections, the symptoms usually occur a week to several months after birth. Meningitis is the most common presentation. Late-onset infection occurs less often than early-onset infection.

Expectant Mother: How can I know if I have GBS?

Nurse: Antenatal Clinics of Hospital Authority and Maternal and Child Health Centres of Department of Health provide a GBS screening test for pregnant women. The objective is to identify women who are colonised with GBS and provide them with appropriate treatment so as to reduce the chances of their newborns developing early-onset GBS infection.

Expectant Mother: So, how is GBS screening test done?

Nurse: The test is done between the 35 to 37 weeks of pregnancy. The doctor or nurse will swab your vagina and rectum and then send the sample to the laboratory for testing. The procedure is simple, fast and painless. And a speculum is not required.

Expectant Mother: What happens if the GBS test is positive?

Nurse: A positive test result means that the pregnant woman is colonised with GBS. We recommend the mother to receive intravenous antibiotics during labour. This greatly helps to reduce the chances of the baby being infected with GBS!

Expectant Mother: If antibiotics are given during pregnancy for women who are colonised with GBS, will this protect their newborns from being infected?

Nurse: Receiving antibiotics during pregnancy is not an effective way to get rid of GBS, because colonisation status can change over the course of pregnancy. The bacteria can reappear following the antibiotic treatment. Therefore, the most effective way to prevent the newborn from being infected with GBS is to receive antibiotics during labour.

Expectant Mother: Should every pregnant woman undergo GBS screening?

Nurse: Actually, not every pregnant woman requires a GBS screening. We recommend some women to receive antibiotic injections during labour, for example: Women who have previously given birth to an infant with GBS infection; Women who have developed a GBS-related urinary tract infection in the current pregnancy; or Women who have already been found to be colonised with GBS before 35 weeks of pregnancy.

Expectant Mother: So, if I have planned a caesarean delivery, do I still need the GBS test?

Nurse: We recommend that pregnant women who have planned to have a caesarean delivery should still be screened for GBS!

Expectant Mother: What will happen if I do not have the test or the test result is not known during labour?

Nurse: Medical professionals may give you antibiotic injections if the following conditions are present during labour: You have gone into labour prematurely that is, before 37 weeks of pregnancy; you have a fever of 38°C; or higher during labour; or your waters have broken for more than 18 hours.

Expectant Mother: Are there any side effects from antibiotic injections?

Nurse: There is a possibility of allergic reaction but the chance of severe allergic reactions causing a life-threatening situation is very low. Health professionals will keep a close eye on the women who have received antibiotics. After the antibiotic injection, if you develop any skin rash or have breathing difficulties, you should report to the health professionals immediately.

Expectant Mother: If I have received an antibiotic injection during labour, will my baby be completely protected from the infection?

Nurse: Antibiotic injections during labour can greatly reduce the chances of early-onset GBS infection but it cannot totally prevent all early-onset infection. Because your baby may also become infected through other sources.

Expectant Mother: If I have a negative result does it mean that my baby will not be infected?

Nurse: The reasons for a negative test result may be: The woman has never been infected with GBS, or the woman has no GBS colonised at the time of testing or it may be a false negative report. So even if the screening result is negative, your baby still has a small chance of becoming infected.

Expectant Mother: If I have GBS colonisation, will my baby need any treatment after birth?

Nurse: Your baby will be referred to a paediatrician after birth. The paediatrician will determine if the baby needs any treatment according to the following factors: Whether the baby has any signs of infection? Whether the baby was born at term? And how much antibiotics have been given during labour?

Expectant Mother: So, when will I know my screening result?

Nurse: The result is available about a week after the test. You will be informed of the result at your next antenatal checkup.

Expectant Mother: If I plan to give birth at a private hospital what can I do?

Nurse: To ensure your private doctor knows about your GBS screening result before the onset of labour, so that timely antibiotic injections can be given if needed, we recommend you approach your private doctor for testing.

Expectant Mother: Oh! I understand now, thank you very much!

Nurse: You are welcome!

Presenter: I believe all of you now should have a better understanding about GBS prevention in newborns. If you have any further enquiries about GBS screening, please consult your health professionals. Wishing all expectant mothers and their babies a healthy and happy life.