Intrapartum Management Relating to the Risk ofPerinatal Transmission of Group B Streptococcus

[摘要] Objective:To reviewthe inicidence of neonatal group B streptococcal (GBS) sepsis and its associated risk factors in our obsterical population.Methods:A computerized perinatal database of over 17,000 births (from 1992 to 1996) wasqueried for the incidence of neonatal GBS sepsis . A more detailed review of 895 births (from thefirst quarter of 1997) was undertaken to identify the incidence of risk factors known to be associatedwith neonatal GBS sepsis.Results:In our institution, 30 cases of neonatal early-onset GBS sepsis were identified inover 17,000 births (or 1.7/1,000 deliveries). Risk factors were identified in 17 of those cases(56%). There were two neonatal fatalities . Chemoprophylaxis was provided in 15% of the totaldeliveries.Conclusions:In spite of the lack of a uniform policy for identifying patients suitable for GBSchemoprophylaxis, we found only a 43% incidence of neonatal GBS sepsis occurring without riskfactors present. Identification of antepartum or intrapartum risk factors in our series, therefore,would have identified the majority of cases resulting in neonatal GBS sepsis, which may havebenefited from intrapartum therapy. Some negative potential consequences of chemoprophylaxisare discussed, raising questions regarding the recent recommendations of the Centers for DiseaseControl and Prevention.

[学科分类] 妇产科学