Group B Strep & Cesarean Section: What You Need to Know

Question
Hi Doctor,

I'm 37 weeks pregnant and tested positive for Group B strep.  I already have a c-section scheduled in two weeks for other reasons.  My doctor doesn't normally even test women with planned c-secs for Group B (I asked for the test to know my status).

(1) I haven't found any information online about what should be done regarding antibiotics in case my membranes rupture prior to my c-section date.  Should I ask that I be given antibiotics prior to a c-sec in such a case?  And if there is no time for antibiotics, should I demand that my baby receive them after his birth?

(2) Even if my membranes don't rupture, should I demand antibiotics for myself or my baby?

(3) Would losing my mucus plug prior to membrane rupture increase chances of the bacteria causing an infection?

Thanks much for your opinion.  

Answer
Dear Elizabeth

Many doctors do not go for group B strept testing in many parts of the world. For the united states, i guess the opposite is true, Im sure that a minority do not ask for it.

If you go into spontaneous vaginal labor or your membranes, ruptured, you should get 1 gram of ampicillin 4 hours before the expected time of delivering your baby. Controversey exisits regarding the administration of antibiotic with C.S. as in this case your baby will not pass through your birth canal (cervix and vagina) where group B strept is there.

Losing your mucus plug is quite a normal event during the process of labor and does not have a remarkable effect on the incidence of infection.

I suggest you consult a neonatologist about your last question whether to give your baby an antibiotic if your membranes do not rupture.

Good Luck