pregnancy

Streptococcus in Pregnancy

Introduction

When we talk about streptococcus in pregnancy, we mainly refer to the presence of a specific beating in the body of pregnant women: Streptococcus agalactiae, better known as beta-hemolytic streptococcus of group B.

Streptococcus in pregnancy raises many concerns for future mothers; this is because the infection sustained by it can be transmitted to the fetus or to the child triggering very serious pathologies.

Infection in Pregnancy

How is Streptococcus acquired and how is it transmitted during pregnancy?

Streptococcus agalactiae is a microorganism naturally forming part of the human bacterial flora. In fact, it is estimated that this bacteria is present in about 10-30% of pregnant women at the rectal level and at the level of the urogenital mucosa.

Under normal conditions, this microorganism is kept under control by the host's immune system. However, in some situations, the body's defenses may decrease, favoring the uncontrolled growth of the streptococcus in question and thus giving rise to the infection. Therefore, in these cases, the streptococcus - already present in the body - from an innocuous diner turns into a pathogenic microorganism.

In pregnant women, the infection with Streptococcus agalactiae is able to cause sepsis, urinary tract infections and amnionitis, an inflammatory pathology with potentially tragic consequences for the fetus.

If the streptococcus does not trigger infection in the mother as it is adequately controlled by the immune system, it can still be transmitted to the baby during birth. This means that a woman carrying streptococcus agalactiae can transmit the bacterium to the newborn even if, in fact, she is not sick.

Neonatal infections

Neonatal Infections and Associated Pathologies

Once in the body of the unborn child during delivery, streptococcus agalactiae - due to the immune defenses not fully developed - could give rise to neonatal infections with very serious consequences. This is why streptococcus in pregnancy generates so many concerns.

This beat, in fact, is able to trigger real infections in the body of the newborn, which can give rise to serious diseases such as septicemia, pneumonia and neonatal meningitis .

Infection of the newborn can occur with early onset (ie immediately after birth, generally within 20 hours), or with late onset (about two or three months after birth). Usually, in the case of early onset, the streptococcus - spreading through the bloodstream - gives rise to septicemia and pneumonia. In the case of late onset, instead, there is a greater probability that the infection gives rise to neonatal meningitis.

However, the possibility that the infection can spread to other body areas (skin, bones, soft tissues, etc.) cannot be excluded, causing further disorders and diseases.

Risk factors

From the estimates carried out it emerged that the probability of transmission of the bacterium from the mother to the child during birth is 70%; although, fortunately, only 1-2% of unborn children develop the infection.

Furthermore, the contraction of the infection by the unborn child can be promoted by a series of risk factors, including:

  • Preterm birth;
  • Body weight lower than normal values ​​(underweight newborn);
  • Prolonged rupture of membranes (over 18 hours).

Prevention

Prevention of Neonatal Infections caused by the presence of Streptococcus in Pregnancy

Given the seriousness of neonatal infections that can occur, the prevention of streptococcus in pregnancy plays a fundamental role.

It is precisely for this reason that most gynecologists recommend future mothers to perform a vaginal swab, a rectal swab and urine culture in the period between the thirty-fifth and thirty-sixth week of gestation.

In the event of a positive response to all or some of the above tests, the doctor may decide to start a prophylactic amphibious therapy immediately. In detail, in these cases, it is particularly important to administer an antibiotic drug intravenously (usually ampicillin) during labor . The adoption of this preventive strategy makes it possible, in fact, to reduce the possibility of transmitting the beat to the newborn by 20 times.

Antibiotic intake long before delivery, on the other hand, is usually ineffective, since streptococcus agalactiae can once again colonize the urogenital and / or rectal tract of the pregnant woman within a short time.

Controls and prophylaxis after birth

Even if the mother has received antibiotic treatment during childbirth, after birth, the child will still be kept under control for a minimum period of 72 hours, in order to completely exclude the presence of any early-onset infection. Moreover, it will be subjected to a series of tampons in order to determine the possible presence of the microorganism.

If, on the other hand, the mother has not been subjected to antibiotic prophylaxis during labor, but there is still the presence of risk factors (eg premature birth, prolonged rupture of the membranes, etc.), the newborn will undergo prophylactic therapy parenterally, usually based on antibiotic drugs belonging to the penicillin family.

Treatment

Pregnancy Streptococcus Treatment

In the event that the streptococcus agalactiae triggers the infection during pregnancy, the mother must be immediately treated with antibiotics, in order to avoid the onset of serious complications for the fetus (such as, for example, amnionitis).

Treatment of streptococcus in pregnancy usually involves the administration of antibiotics such as penicillins (generally ampicillin or benzylpenicillin), cephalosporins, macrolides or aminoglycosides.

In the case of streptococcus infection in newborns, antibiotic treatment is similar to that described for the mother, of course, with appropriate dosage adjustments.