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Universal screening for group B streptococcus: recommendations and obstetricians' practice decisions
J Gigante1, G B Hickson, S S Entman
1Department of Pediatrics, Vanderbilt University, Nashville, TN.
Obstetrics and Gynecology
|March 1, 1995
Summary
Most obstetricians do not support universal group B Streptococcus (GBS) screening for pregnant women but will treat based on positive culture results. Clinical factors and physician traits influence treatment decisions for GBS chemoprophylaxis.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Prevention
- Maternal-Fetal Medicine
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infection.
- Current guidelines recommend screening pregnant women for GBS.
Purpose of the Study:
- To assess obstetricians' opinions on universal GBS screening in pregnancy.
- To evaluate obstetricians' treatment responses to positive GBS cultures.
- To identify physician characteristics influencing GBS treatment decisions.
Main Methods:
- A mail survey was conducted among 194 obstetricians in middle Tennessee.
- Obstetricians were presented with six clinical scenarios to gauge treatment decisions for GBS.
- Physician practice and personal characteristics were also collected.
Main Results:
- Only 28% of surveyed obstetricians agreed with universal GBS screening.
- However, 74% would treat based on a positive GBS culture alone.
- Positive GBS culture, prolonged rupture of membranes, and preterm labor strongly predicted treatment.
Conclusions:
- Most regional obstetricians favor selective treatment over universal GBS screening.
- Intrapartum antibiotic prescription for GBS is common with positive cultures.
- Clinical risk factors and physician-specific traits independently impact GBS treatment decisions.