another ob/gyn question?

Question

what exactly do they do when the doctor tells you that they need to do a vaginal and rectum check up to see if you have any bacteria before your babys born? has anyone had this done to them?

Answer 1

Yes, they do this in your 36th week to check for strep b. They just take what looks like a big Q-tip and take a swab. It takes a few seconds and does not hurt. They will also do a pelvic exam to check your cervix at this time to see if things are moving along. If you have the strep infection then you will need antibiotics during your labor. I did not have it for my first pregnancy but do have it this time.

Answer 2

I can't think of the name, something like Strep B. Some kind of bacteria that usually resides in the intestines. For some reason or other, it multiplies down there and can be passed on to the baby making them sick. It's not an STD. If you test positive, it's no big deal, when you go into labor, they'll hook you up to an IV and give you a bag or two of antibiotics. They have to do it then, can't do it before, because I guess the bacteria just grows so fast. Dr. will just take a cotton swab and do a quick rub of the area and send of for tests.

Answer 3

Don't know about the rectum...I have 3 babies and never had that! Vaginal I know they test for std's, at least in our state, at the beginning of a pregnancy. At around 37 weeks they check for Group B, which is a normal bacteria about 30% of women carry around, but it is not harmful to us. However, it can be harmful to a baby when they are being born, so they test pregnant women for it. If you do have it, they simply administer antibiotics through your iv during delivery. No big deal.

Answer 4

Are you talking about the Group B Strep test?
It's just a vaginal and rectal swab. Doesn't hurt at all. And no speculum required.
They just take a great big Q-tip looking thing and swab your vagina and rectum.
My midwives even let the patients do it themselves.
It's an important test because if you are GBS+ and pass it to the baby then it can be serious. Transmission can be prevented by getting antibiotics in labor.

Answer 5

They are checking for Strep B bacteria. They always do it right before you give birth. It's nothing too serious and you can barely feel it, but it is necessary and if they find the bacteria, all you have to do is take some antibiotics for about a week and it clears it right up. No big deal.

Answer 6

I really have no clue on the rectum thing, but I had a vaginal exam every week for the month leading up to my sons birth. They're just testing for Group B strep, stuff like that...nothing to worry about. Still confused on the rectum thing, but hey...

Answer 7

They always check the vagina before the baby is born . They did that to me w/both kids. If you have bacteria and the baby comes down the canal it can contract it too and get real sick. About the rectum thing I don't know about that

Answer 8

It's well known that the percentage of babies who actually benefit from intrapartum antibiotics is very small. And, increasingly, the routine use of chemoprophylaxis (antibiotics) during labor is causing problems with resistant GBS or resistant e. coli.

So, in this area, some OBs and pediatricians have a new approach; for cases of prolonged rupture of membranes, they're only giving antibiotics if the mom runs a fever. Otherwise, they just do a simple blood test on the baby (can be done from cord blood or a heelstick if they miss the cord blood opportunity) to check for C-reactive protein. This is an indicator of an acute infection. If it's negative, everyone can be reassured that baby's fine, even though mom didn't get antibiotics; if it's positive (for whatever reason!), then baby will be appropriately treated for an acute infection. This has great potential for focusing the treatment where it is most needed and not exposing all the others to unnecessary side effects and increased risks from resistant bacteria.

Group B Strep is a normal bacteria that is present in 20-30% of women's vagina. It becomes important in childbirth for you if you develop signs of an infection, which can be pretty nasty (after you've delivered). The infection can be of the womb lining (endometritis) or wound if you have a section.

Much more importantly for your baby is the disease called Early Neonatal Group B Streptococcal Septicemia (ENGBSS). This is occurs after the baby passes through an infected birth canal and the infection spreads to his blood stream. 30% of affected neonates develop meningitis and half of these sustain permanent neurological injury. It carries a 20-30% mortality rate.

Neonatal carriage occurs in 35-50% of labours where a swab during labour was positive and in 25% where there was a positive maternal swab at some point in the antenatal period. Only 1-2% of neonates colonised develop ENGBSS.

There's no perfect answer. In most cases, a mom who has GBS will also have GBS antibodies that are passed to the baby through the placenta. [ref: Williams Obstetrics] Nature's not stupid. In rare cases of either very high colonization or unhealthy mom or baby, the baby could be overwhelmed and then require antibiotic treatment.

However, the treatment carries risks of its own - 10% of moms have a mild allergic reaction to the antibiotics - 1 in 10,000 experience anaphylactic shock, which is life-threatening to both the mom and baby.

In addition, 4% of strains of GBS are now antibiotic-resistant. Again, nature's not stupid.

If you carry a resistant strain of GBS, the antibiotics will kill off all the innocuous, normal bacteria that would keep the antibiotic-resistant GBS in check, so that the only thing left is the resistant strain, which tends to be more virulent than the regular strain. This is a horrible situation for a newborn with an immature immune system.

In addition, of course, receiving antibiotics in labor is one of the dominoes in the cascade of interventions and increases overall risk due to the compounded risks of the cascade.

There's no perfect answer. Alternative approaches to reducing colonization may be the most sensible solution.



[from ob-gyn-l]

Group B strep is not so virulent. It is normal vaginal flora in pregnancy (20%) of all women have it. It only causes a problem in 1 of 400 babies exposed to it. There are to my knowledge no studies associating it with miscarriage. Why is everybody so bent out of shape about this organism. The real problem is what is there about that 1 baby in 400 that is so abnormal that allows this benign bug to harm him/her.

Sources of GBS Infection

Any caregiver can introduce GBS also. I have watched docs and midwives when they do vaginals. They lube up and then do this little wipe of the vulva with their fingers (almost like foreplay) to lube up the woman. During that wipe they can easily pick up GBS and insert it with their fingers. And it is not unusual for anyone who has delivered in hospital to have GBS.

As everyone knows, docs do vaginals on the first visit of a pregnancy (for pelvimetry and STD checks). I believe that with that first vaginal they can introduce GBS to the cervix and all too often do.

If a caregiver is going to do a vaginal in early pregnancy (& even in late) then the vulva should be wiped first with a microbial swab.

Far better to avoid GBS then have to treat it.

Answer 9

They could be looking for MRSA which is a common bacteria that is very antibiotic resistant. Many adults carry it without even knowing but to an infant it can be fatal. It may be common in your area or there could be an outbreak in the hospital were you are going. I have had three kids and have never been checked like that before. I would ask your Doc what exactly he is looking for and tell him you asked around and no one seems to have heard of this and ask why he thinks it is necessary.

Answer 10

If you're talking about the Group B Strep test around 36 weeks then its simple: they take a swab and run it top to bottom from your vagina to your anus. They then test it to see if you have the bacteria present, no biggie.