Hospitals and Healthcare Providers
Universal Screening Algorithm
| FIGURE 2. Indications for intrapartum antibiotic prophylaxis to prevent perinatal GBS under a universal prenatal screening strategy based on combined vaginal and rectal cultures colleted at 35-37 weeks' gestation from all pregnant women |
| Vaginal and rectal cultures colleted at 35-37 weeks' gestation for ALL pregnant women (unless patient had GBS bacteriuria during the current pregnancy or a previous infant with invasive GBS disease) |
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Intrapartum prophylaxis indicated
- Previous infant with invasive GBS disease
- GBS bacteriuria during current pregnancy
- Positive GBS screening culture during current pregnancy( unless a planned cesarean delivery , in the absence of labor or amniotic membrane rupture, is performed0
- Unknown GBS status (culture not done, incomplete, or results unknown) and any of the following:
- Delivery at <37 weeks' gestation*
- Amniotic membrane rupture ≥ 18 hours
- Intrapartum temperature > 100.4°F (≥38.0°C)†
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Intrapartum prophylaxis not indicated
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Previous pregnancy with a positive GBS screening culture (unless a culture was also positive during the current pregnancy)
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Planned cesarean delivery performed in the absence of labor or membrane rupture (regardless of material GBS culture status)
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Negative vaginal and rectal GBS screening culture in late gestation during the current pregnancy, regardless of intrapartum risk factors
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* If onset of labor or rupture of amniotic membrane occurs at <37 weeks' gestation and the is a significant risk for preterm delivery (as assessed by the clinician), a suggested algorithm for GBS prophylaxis management is provided (Figure 3).
†If amnionitis is suspected, broad-spectrum antibiotic therapy that includes an agent known to be active against GBS should replace GBS prophylaxis. |
Source
Centers for Disease Control and Prevention. Prevention of Prenatal Group B Streptococcal Disease. MMWR 2002;51 (No. RR-11):[8].
Page Last Modified: April 20, 2008
Content Last Reviewed: April 20, 2008
Content Source: National Center for Immunization and Respiratory Diseases
