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Subject:
From:
Chris Hafner-Eaton <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 10 Mar 1997 08:25:45 -0800
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 Anne:  There's a combination of things going on with the Beta
Strep-prophylactic antibiotics situation.  First, there IS an increase in
the diagnostic rate because there's been an increased rate of testing;
however, that also means that there's more false positives out there too.
Much of this was prompted by a published study (don't have the citation
right here) on the prevalence rate of B-Strep in pregnant women and the
rate of infection.  Anyone have the study handy?  In this article, the
authors recommended a change in OB protocol to administer IV antibiotics
throughout labor to prevent the transmission of B-Strep to the infant.
Second, there probably IS an actual increase in the incidence--apart from
the diagnositc side.  Third, the use of routine vaginal exams, AROM, and
internal fetal monitors has increased the rate of transmission to the
infant.  There is speculation that transmission is not very likely in the
actual passage through the vaginal canal, but that all of these
interventions allow a much greater time of exposure and in conditions where
the baby may still be "breathing/swallowing" amniotic fluid, opening
his/her eyes, etc.  Last, YES all of this IV antibiotic DOES lead to
greater problems with Candida/yeast...has anyone out there implemented a
counter prophylatic Nystatin protocol?
Chris

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