Oops that initial stands for group B. strep. I have been out of the loop for
a while so this may be old news but, everyone agrees that intrapartum
prophylaxis can dramatically reduce the risk of the baby getting Group B.
Strep disease. However, certain women are at higher risk than others. Thus
both the Amercian Acaemy of Pediatrics and the amercian College of Ob/GYN
recommend treatment for ONLY high risk women. THese include:
Those with rupture of membranes >18 hours (and perhaps women with greater
than 12 hours of rupture who are not expected to deliver until past 18
hours), preterm babies, maternal fever and previous child with group B> strep
disease. Thedifference between the AAP and AAcog at present is that the AAP
recommends screening all women at about 28 weeks gestation but treating only
those with risk factors and AACOG recommends treated all women with risk
factors and only screening at delivery if you are already treating. The AAP
thus overscreens and treats only those who need it, AACOG overtreats and
screens only those who need it. The big question is then what do you do with
the healthy asymptomatic child.... The debate continues (I have personally
been involved in creating the protocols for three different hospitals - all
different!)
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*  Deena Zimmerman MD MPH IBCLC                         *
*  Department of Pediatrics                        *
*  UMDNJ-Robert Wood Johnson Medical School        *
*  1 RWJ Place                                     *
*  New Brunswick, NJ 08903                         *
*                                                  *
*      phone (908) 235-7248                        *
*      fax   (908) 235-7345                        *
*      email  [log in to unmask] (internet)        *
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