Publication
Compliance with screening for and recommended management of maternal group B streptococcus carriage in pregnancy.
Publisher:
Wiley
Date:
25-04-2019
DOI:
10.1111/AJO.12977
Abstract: Universal screening of pregnant women at 35–37 weeks gestation is recommended for detection of anogenital group B streptococcus carriage. Intrapartum chemoprophylaxis is prescribed to carriers to prevent transmission to babies, reducing early‐onset neonatal group B streptococcal sepsis. To review compliance with, and the effects of education on group B streptococcus screening and intrapartum chemoprophylaxis practices at The Royal Women's Hospital, Melbourne, Australia. A retrospective audit of women delivering in February 2016 and February–March 2017 was conducted. In February 2017, updated early‐onset group B streptococcal disease prevention guidelines were released and promoted with targeted education of clinical staff. Compliance was considered appropriate if practices followed up‐to‐date local protocols. Screening rate for group B streptococcus was 84.4% (599/710) and carriage rate 19.5% (109/558), while intrapartum antibiotic prophylaxis was optimal in 83% of those labouring greater than four hours (39/47). There was no significant difference in compliance between 2016 and 2017. Of 113 women with unknown group B streptococcal status at delivery, only five of 33 (15%) with clinical risk factors for early‐onset neonatal disease received intrapartum prophylaxis. Compliance remained stable, with no change during or after implementation of new protocols. Compliance with protocols was low for cases with unknown group B streptococcal status at delivery but with the presence of one or more clinical risk factors for early‐onset group B streptococcal sepsis.