Kenyon S, Brocklehurst P, Blackburn A, Taylor DJ
Antenatal screening and intrapartum management of Group B Streptococcus in the UK. [Journal Article]
BJOG 2004 Mar; 111(3):226-30.
OBJECTIVE: To determine whether there has been any change in UK policy for the screening and intrapartum management of Group B Streptococcus in pregnancy over a two year period.
DESIGN: Two national survey's of practice carried out in 1999 and 2001.
SETTING: All obstetric units in the UK. POPULATION: Clinical directors of maternity services.
METHODS: A questionnaire was sent to all clinical directors of maternity services in the UK requesting information about their policy and practice with respect to antenatal screening for Group B Streptococcus colonisation. Reminders were sent after one month.
MAIN OUTCOME MEASURES: Number of maternity units in the UK screening and offering intrapartum antibiotic prophylaxis for Group B Streptococcus colonisation in pregnancy.
RESULTS: The response rates were 84% in 1999 and 82% in 2001. Of the responding units, six (3%) in 1999 and four (2%) in 2001 used vaginal swab based screening for Group B Streptococcus colonisation in the antenatal period. In 1999, intrapartum antibiotic prophylaxis was offered to women with a previous baby affected by Group B Streptococcus in 85% (176/207) of maternity units and in 2001 this had risen to 95% (193/203). Similarly, in 1999 intrapartum antibiotic prophylaxis was offered to women who were known carriers of Group B Streptococcus in 87% (179/207) of maternity units and in 2001 this had risen to 95% (193/203). Appropriate dosage of a recommended antibiotic was prescribed in 7% (9/123) units in 1999 and in 20% (35/178) units in 2001.
CONCLUSIONS: Although intrapartum antibiotic prophylaxis for women at high risk of giving birth to babies with Group B Streptococcus is widely practiced in the UK, a programme of antenatal screening for Group B Streptococcus colonisation has not been adopted along the lines advocated in the USA. There therefore remains an opportunity to evaluate such a screening programme in a randomised trial.
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