Group B Streptococcal Bacteriuria in Pregnancy: An Evidence-Based, Patient-Centered Approach to Care

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Maternal-Fetal Medicine

Background:

• Group B Streptococcus (GBS) bacteriuria in pregnancy necessitates management to decrease pyelonephritis and neonatal GBS disease.
• Universal screening and management are standard in the US, but patient refusal of recommendations occurs.

Purpose of the Study:

• To discuss evidence-based, patient-centered care for GBS bacteriuria in pregnancy.
• To explore ethical integration of patient preferences when guideline recommendations are declined.

Main Methods:

• Case study approach.
• Review of evidence-based practices for GBS bacteriuria management.
• Discussion of ethical considerations in patient-centered care.

Main Results:

• Guidelines exist for GBS screening and management, but patient autonomy must be respected.
• Patient-centered care involves shared decision-making, especially when patients decline standard protocols.
• Ethical frameworks support incorporating individual values into GBS management plans.

Conclusions:

• Effective management of GBS bacteriuria in pregnancy requires balancing evidence-based guidelines with patient autonomy.
• Ethical considerations are paramount when addressing patient refusal of GBS screening, treatment, or prophylaxis.
• A patient-centered approach ensures that care aligns with individual values and preferences while aiming for optimal maternal and neonatal outcomes.