Group B Strep in Pregnancy: Symptoms, Risks and When to Seek Help
Posted on in Medical Negligence
July 8th – 14th is Group B Strep (GBS) Awareness Week and as one of Group B Strep Support's longest serving legal partners, we are delighted to do what we can to help raise awareness of GBS.
What is Group B Strep?
Group B Strep is a naturally occurring bacterium found in the digestive system and, for some people, in the vagina or urinary tract. It is estimated that around two to four in ten pregnant people carry Group B Strep without experiencing any symptoms.
Carrying Group B Strep is not an infection and in most cases, it causes no illness or health problems for the mother.
However, during labour and birth, the bacteria can sometimes be passed to a baby. While most babies exposed to Group B Strep remain healthy, a small number can develop a serious infection requiring urgent medical treatment.
Why does raising awareness of GBS matter?
For those infants impacted by Group B Strep, the impact can be devastating. On average, every month across the UK:
- 66 babies are diagnosed with a GBS infection.
- 56 (84%) will make a full recovery.
- 6 babies survive but will suffer long-term physical or mental disabilities.
- 4 babies die from their GBS infection.
As lawyers specialising in medical negligence claims and in GBS cases in particular, so often we find that many families only become aware of GBS after their baby has become seriously ill.
Through no fault of their own, parents are then left with a sense of guilt and regret wishing that they had known more.
This is borne out by surveys by GBSS which showed that two-thirds of new and expectant mothers (66%) are not receiving any information about GBS from a healthcare professional, despite 2017 guidance from the Royal College of Obstetricians & Gynaecologists (RCOG) recommending that this information be provided to all pregnant women.
Knowing about GBS when you are pregnant or shortly after your baby is born can however make a huge difference because crucially most GBS infections in newborn babies can be prevented. Early treatment and intervention when an infection does arise, can and does save lives.
When can babies develop Group B Strep infection?
Group B Strep infections are divided into two categories:
Early-onset Group B Strep develops during the baby's first six days of life, with most babies becoming unwell within the first 12 to 24 hours after birth. These infections are usually acquired during labour or birth and, in many cases, can be prevented through appropriate maternity care.
Late-onset Group B Strep occurs between seven and 90 days after birth. These infections are less common and are generally acquired from the community rather than during birth. Unfortunately, there are currently no known ways to prevent late-onset Group B Strep infection, making early recognition and urgent treatment especially important.
What are the symptoms of Group B Strep infection in babies?
Most babies exposed to Group B Strep do not become ill, but parents should be aware of symptoms that require immediate medical attention.
These include:
- Difficulty breathing or grunting.
- Being unusually sleepy or difficult to wake.
- Poor feeding.
- Floppiness or reduced movement.
- A high or low temperature.
- Pale, blotchy or blue skin.
- Irritability or excessive crying.
If a newborn baby develops any of these symptoms, urgent medical assessment is essential. Early diagnosis and treatment can significantly improve outcomes.
Can you be tested for Group B Strep?
Unlike some other countries, the NHS does not routinely screen all pregnant people for Group B Strep. Instead, it follows a risk factor-based approach to identify women whose babies have a higher chance of developing early-onset Group B Strep infection.
Those who carried Group B Strep in a previous pregnancy should also be offered appropriate advice and either testing or intravenous antibiotics during labour, depending on their individual circumstances.
How can the risks be reduced?
Relevant information
- All pregnant people should be provided with a patient information leaflet about GBS
Antenatal Screening
- Currently, the NHS takes a risk-factor based approach to identifying GBS - using risk factors to determine which pregnant women and people should be offered testing or antibiotics.
- Healthcare professionals should ensure that any known risk factors for Group B Strep (such as Those who have been identified as carrying GBS in a previous pregnancy) are accurately recorded and communicated throughout pregnancy.
- Where national guidance recommends testing or intravenous antibiotics during labour, these discussions should take place in good time so parents can make informed decisions.
- Clear communication between community midwives, obstetric teams and labour ward staff is essential to ensure appropriate care is provided.
Antibiotics
Most early-onset GBS infections can be prevented with the use of intravenous antibiotics, given to people during labour if their baby has a higher chance of developing an early onset GBS infection.
You should be offered intravenous (IV) antibiotics during labour if you:
- have had a urine infection caused by GBS.
- have had a GBS positive test, conducted either by the NHS or another accredited laboratory; or
- have previously had a baby that was diagnosed with GBS infection.
If your waters break after 37 weeks and you are known to carry GBS then you should be offered an induction of labour straightaway to reduce the risk of your baby being exposed to GBS. You should also be offered intravenous antibiotics once induced.
If you are not known to carry GBS but develop signs of infection while you are in labour, then you will be offered intravenous antibiotics. This will be aimed at treating a wide range of infections, including those caused by GBS.
If your labour starts before 37 weeks, then you will be recommended to have intravenous antibiotics even if you are not known to carry GBS.
At present, there are no known methods to prevent late-onset GBS infection. These cases cannot therefore be prevented, and the key is early identification of the infection and urgent treatment.
Where does treatment go wrong?
Most healthcare professionals provide excellent care, and the majority of pregnancies involving Group B Strep are managed safely.
When could a compensation claim arise?
- If the treatment that you or your baby received was negligent, causing you or your baby either injury or harm, you may be able to bring a claim for compensation as a result.
- The process of bringing a claim is not about punishing those who have made a mistake, but rather about putting you back in the position you would have been in had the negligence not occurred (in so far as money ever can in this situation).
- No amount of money will ever adequately compensate for the loss of a baby but crucially if your child has been left with long term disability and your claim is successful, it will result in financial compensation which will help secure appropriate care and support in the future.
- In early-onset cases, the typical issues we see tend to include:
- Failures to advise mothers of the risks if they have been identified to carry GBS in a previous pregnancy and to offer testing or antibiotics.
- Failures to recognise from the records that a mother has been noted to carry GBS and therefore offer intravenous antibiotics during labour; and
- Failures to pick up and act upon the signs of infection and treat the baby promptly after they are born.
- For late-onset cases as the GBS infection cannot be prevented, the key issues that we see are around failures to appropriately identify the infection and expedite the necessary urgent treatment
How can we help?
If you or a loved one has suffered due to failures in the diagnosis, treatment, or management of a Group B Streptococcus (GBS) infection, our experienced team can help you seek the compensation you deserve and provide support in planning for the future.