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Quick clinical scenario:
28 year old at 30 weeks comes in with preterm labor. GBS cultures are obtained and eventually come back positive. Patient is eventually discharged. No history of GBS bacteruria and no prior infants with invasive GBS disease.
Two questions:
1. Should we be obtaining GBS cultures on this patient at 35-37 weeks? Or is this patient being managed as GBS positive now on?
2. If GBS cultures were repeated at 35-37 weeks and they subsequently are negative. Are we managing the patient based on this negative value now?
3. If the patient returns in active labor at 39+ weeks and has not had any additional GBS testing since the testing done at 30 weeks, treat or not treat?
This scenario is in reference to the ACOG ID supplement on the website.
My thought was the test will have an inherent false negative rate and that one couldn't rely on that to assume transient colonization in light of a previous positive culture during the pregnancy.
I am looking for the "test" answer to this (CREOGS and boards etc)
28 year old at 30 weeks comes in with preterm labor. GBS cultures are obtained and eventually come back positive. Patient is eventually discharged. No history of GBS bacteruria and no prior infants with invasive GBS disease.
Two questions:
1. Should we be obtaining GBS cultures on this patient at 35-37 weeks? Or is this patient being managed as GBS positive now on?
2. If GBS cultures were repeated at 35-37 weeks and they subsequently are negative. Are we managing the patient based on this negative value now?
3. If the patient returns in active labor at 39+ weeks and has not had any additional GBS testing since the testing done at 30 weeks, treat or not treat?
This scenario is in reference to the ACOG ID supplement on the website.
My thought was the test will have an inherent false negative rate and that one couldn't rely on that to assume transient colonization in light of a previous positive culture during the pregnancy.
I am looking for the "test" answer to this (CREOGS and boards etc)
