Medical negligence partner Emmalene Bushnell discusses the need for a GBS screening programme for pregnant women
L was born in May 2013, the fourth child of Mr and Mrs B.
Mrs B had some yellow vaginal discharge at the time of induction of her labour and asked for a swab to be taken to check for infection. She was reassured by the midwife that there was nothing to be concerned about. L’s delivery went smoothly and Mrs B and L were discharged home the same day.
The following morning Mrs B noticed that L had developed a rash and immediately sought medical advice. She was told to wait for a visit from the community midwife, which took place four hours later.
By then L had a high pitched scream and her condition was getting worse. An appointment was made with a Paediatrician for later that afternoon.
When L was finally seen by a Paediatrician she was thought to be having seizures and had limp limbs. She was grunting with some subcostal recessions (in-drawing of the chest wall below the ribs). L had a blanching rash all over her limbs and abdomen of 1-2cm diameter round red spots, with bruising also noted around her groin and feet. L was noted to be drowsy, rolling her eyes back, clenching both arms in the air and had a high-pitched cry.
The initial impression was that L had GBS sepsis with secondary seizures and antibiotics were administered immediately.
However, sadly L was found to have suffered brain damage as a result of GBS septicaemia. Life support was removed and, tragically, L passed away three days after her birth.
Group B Streptococcus (GBS) is a normally occurring bacterium. Between 20-30% of women carry GBS in their intestines without symptoms and around 25% of women of childbearing age carry GBS in the vagina. These bacteria can sometimes be passed to the baby during delivery.
Newborn GBS colonisation is normal and does not require treatment with antibiotics. However, since the 1970s, GBS has been recognised as the most common cause of severe bacterial infection in newborn babies in the UK. GBS usually presents in newborns within the first 24-48 hours after birth and can result in disease around the time of birth and up to three months of age, although rare cases occur after this time.
Antibiotics are given to a pregnant woman, whose baby is considered to be at an increased risk of developing GBS infection, as soon as possible following the onset of labour. In addition, most babies who become infected with GBS can be treated successfully and make a full recovery.
However, even with the best medical care, GBS infection can cause life-threatening complications, such as septicaemia (blood poisoning), pneumonia (infection of the lungs) and meningitis (infection of the brain lining). Further, around 20% of babies who survive the infection will be affected permanently, with problems such as cerebral palsy, deafness, blindness and serious learning difficulties attributable to the infection.
Despite this, in the UK there is no national screening programme to check if a pregnant woman is carrying GBS.
The charity Group B Strep Support provides potentially life-saving advice regarding GBS.