PLD.40 Effective identification and management of Group B Streptococcus in Pregnancy and Labour


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Abstract

BackgroundAt present Group B Streptococcus infection remains the most common cause of early onset neonatal sepsis. Routine screening of all pregnant women for GBS carriage is not currently practised in the UK. Women identified as being GBS positive in their current pregnancy should be offered intra-partum antibiotics.1 IV Benzyl penicillin 3g stat following onset of labour followed by IV Benzyl penicillin 1.5 g every four hours until delivery is recommended. The first dose should be given at least 2 h prior to delivery.AimThe audit was designed to assess whether the Obstetrics and Neonatology teams are compliant with trust and RCOG guidance on management of Group B Streptococcal Disease. To implement changes to improve compliance if necessary.ObjectivesStandards of 100% are expectedAre GBS positive mothers offered antibiotics routinely during labour?Are we correctly investigating those at risk of GBS sepsis?Are we observing those babies at risk as per guidelines?Are we appropriately treating at risk babies with antibiotics?Expected outcomeImproved outcome of babies born to GBS positive mothers. Adherence to the local hospital guideline and the RCOG guideline on “Prevention of early onset neonatal GBS disease” no: 36.MethodsThis audit has been undertaken in collaboration with the Neonatology team. Specific performa for obstetric and neonatal data collection was used to retrospectively collect data from January 2012–August 2012. A total of 345 GBS positive mothers were included in the audit. They were identified as those women who received a postal letter informing them of their positive GBS result.Results39% of patients had documentation in green notes of GBS positive status23% had informing letter filed in the notes47% received intrapartum Abx40% received Abx within the Trust guideline timeframe.

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