Case Study 2: Group B Strep during Pregnancy Pathophisiology/Etiology: S agalactiae is a gram-positive coccus that, when cultured on sheep blood

agar, forms glistening gray-white colonies with a narrow one of beta hemolysis! "t is an invasive encapsulated organism that is capable of producing severe disease in hosts with compromised immune systems! Group B streptococcal infection in the absence of associated comorbid medical conditions is rare! #he virulence is of S agalactiae is related to the polysaccharide to$in it produces! "mmunity is mediated by antibodies to the capsular polysaccharide and is serotype-specific! Group B streptococci coloni e the vagina, gastrointestinal tract, and the upper respiratory tract of healthy humans! %ow it enters is not &uite certain, but possible areas include the s'in, genital tract, urinary tract, and respiratory tract! Signs and Symptoms: (or women who get group B strep during their pregnancy there are not any signs or symptoms usually that the mother herself has GBS! %owever if the mother does have it there are certain signs that may indicate the baby will be more li'ely to receive the GBS from his)her mother! #hese symptoms include labor or rupture of membrane before *+ wee's, rupture of membrane ,- hours or more before delivery, fever during labor, a urinary tract infection as a result of GBS during your pregnancy and a previous baby with GBS disease! Signs and symptoms of early onset GBS are those that occur with an hour of delivery, they include breathing problems, heart and blood pressure instability, gastrointestinal and 'idney problems, sepsis, pneumonia and meningitis! #he signs and symptoms of late onset GBS, which usually show up within a few wee's or months of delivery, are mostly .ust meningitis! /ate onset GBS is much more rare than early! Diagnosis: GBS is very rare in pregnant women however because of the coloni ation being in the vagina the baby may receive it during birth if the mother has it! Because the outcome of a baby receiving group B strep during pregnancy can be so severe and even lead to death all women are routinely screened for it between the *0th and *+th wee's of pregnancy because studies have shown that screening within 0 wee's of delivery is most accurate in predicting the GBS status at birth! 1 routine screening including a swab of both the vagina and rectum is ta'en within this time interval! #he sample is ta'en to a lab where the culture ta'en is analy ed for any presence of GBS and the results are normally available within 22 to 2- hours! Medical/Surgical Treatment: 3uring the delivery the mother will receive antibiotics, normally penicillin, through an "4 to prevent the baby from getting it! 1ntibiotics given before labor begins may help get rid of the women5s GBS but it will not prevent the mother from transmitting to her baby! "f the mother is at low ris' then she may choose to not go through with the antibiotics and there are herbal remedies that the mother may ta'e 2-* wee's before delivery! Prognosis: #he prognosis is very good for women whom have tested in the appropriate time frame for their GBS! (or women who are tested positive but not in the high ris'

category there is a one in two hundred chance that their baby will develop GBS if they have not chosen to have antibiotics and a one in four thousand chance if they do decide to treat their GBS with antibiotics! Psychological/Social: Because it usually ends with the baby not receiving the GBS there are not normally any psychological and or social implements! %owever in the rare cases of e$treme infant illness or even death the mother may have some issues with depression and some women may have an$iety trouble if they are high ris' and worry about their baby becoming ill! Reference: 6Group B Strep "nfection: GBS!6 American Pregnancy Association! 7!p!, 8ar! 29,,! :eb! ,+ 7ov! 29,*! 6Streptococcus Group B "nfections !6 Medscape! 7!p!, n!d! :eb! ,+ 7ov! 29,*!