What is Group Beta Strep (GBS) and why do we test
for it?
Group
Beta Strep (GBS) is a type of bacteria that is found in the lower intestine
and/or vagina of 10-35% of all healthy adult women. GBS bacteria are a normal
part of the commonly found bacteria of the human body. Ordinarily, the presence
of GBS does not cause problems, however, in certain circumstances, GBS bacteria
can invade the body and cause serious infection; this is referred to as Group B
disease. Group B strep should not be confused with Group A Strep, which causes
strep throat. A person whose body carries GBS bacteria but who does not show
signs of infection is said to be “colonized”, however, GBS colonization is not contagious. GBS is naturally occurring in
the bacteria of both women and men. Since it is commonly found in the vagina of
women, however, it is not a sexually transmitted disease. GBS bacteria usually
do not usually cause genital symptoms or discomfort and are not linked with
increased sexual activity. Women who carry GBS do not need to change their
sexual practices.
What
is the testing procedure?
The
testing recommended: during 35th to 37th week of
pregnancy. The test involves collecting mucous with a cotton swab from the
lower vagina. It takes a moment. The culture is then sent to a laboratory for
evaluation. The test results are usually ready in 3 days.
Unfortunately, the test is
not perfect and it may miss approximately 5% of women who carry GBS. The
bacteria tend be transient (to come and go in cycles) and a woman may test
negative at the time of the culture and have colonization at the time of
delivery. Fortunately, the test is accurate and will not give a false positive
result. A positive culture means that a woman is colonized with GBS. It
does not mean that she has GBS disease or that her baby will become ill.
Rather, it means that the care provider must plan labor and delivery and
newborn care with this in mind.
My Consent form for GBS includes these options:
□ I choose to screen for GBS
between 35-37 weeks. If I am GBS
positive, I will accept intravenous antibiotics in active labor. I may also use alternative therapies if I
desire, but I am fully aware that there is no research to document any efficacy
in preventing GBS infection.
□ I choose to screen for GBS between 35-37
weeks. If I am GBS positive, I decline
intravenous antibiotics in active labor.
I may also use alternative therapies if I desire, but I am fully aware
that there is no research to document any efficacy in preventing GBS
infection.
□ I decline to screen for
GBS. Instead I choose the risk-based GBS
management strategy. If I develop any of
the risks for increased GBS infection, I will accept intravenous antibiotics. I may also use alternative therapies if I
desire, but I am fully aware that there is no research to document any efficacy
in preventing GBS infection.
□ I decline to screen for
GBS and I decline to accept intravenous antibiotics should I develop any of the
risks for increased GBS infection. I may
use alternative therapies if I desire, but I am fully aware that there is no
research to document any efficacy in preventing GBS infection.
According to the CDC, if you have tested positive
and are not in the high risk category, then your chances of delivering a baby
with GBS are (8):
· 1 in 200 if antibiotics are
not given
· 1 in 4000 if antibiotics
are given
Are certain babies more likely to develop GBS disease?
Premature babies, with their
less mature immune systems are more vulnerable than term babies. However, since
most babies are born at term, 70% of babies who develop the disease are term.
Risk
Based Management
Which
women are more likely to develop GBS disease?
· Women who test positive for GBS colonization at 35-37
weeks
· Having already given birth to a baby who had GBS
infection
· GBS bacteria in the urine (bacteriuria, either with or
without symptoms)
· Having the water bag break for more than 18 hours
prior to delivery
· Onset of labor or the water bag breaking before 37
weeks
· Developing a fever higher than 100.4 F
How
is the baby tested for GBS disease?
Babies
who develop the signs of GBS disease (stiffness, limpness, inconsolable
screaming, fever, refusal to feed) must be evaluated immediately by a
pediatrician. Blood tests, cultures and x-rays determine whether the baby has
GBS disease, and treatment should begin immediately.
How
can GBS disease be prevented?
Antibiotics
such as penicillin administered through the vein (an IV) 4 to 6 hours prior to
delivery to women who have a positive GBS test or who have certain risk factors
will effectively prevent most GBS infections in women and their babies.
Antibiotics
can cause side effects, which are usually mild, but can be severe; their use
should be limited to women who have one or more of the risk factors.
Alternatives to penicillin may be used. Risks and benefits of antibiotics
should be considered.
Cesarean
sections are not likely to prevent GBS disease.
Unfortunately,
no plan is 100% effective. Some women with GBS escape detection because they do
not have the risk factors. Therefore, medical standard of care dictates that
all women be tested with each pregnancy. According to the Centers for Disease
Prevention and Control and the American College of Obstetricians and
Gynecologists, routine prenatal culture at 35-37 weeks along with IV
antibiotics during labor for women who culture positive for GBS offers the very
best protection available to the newborn.
Women
with GBS colonization may breastfeed their babies.
Garlic is a natural
antibiotic
Garlic has been shown in vitro (in laboratory
petri dishes) to kill bacteria and also yeast. In some important research done
in China (1), garlic was shown to inhibit the growth of all of the following
microorganisms: Escherichia coli, Salmonella typhimurium, Vibrio
parahaemolyticus, Pseudomonas aeruginosa, Proteus vulgaris, Staphylococcus
aureus, Mycobacterium phlei, Streptococcus faecalis, Bacillus cereus and
Micrococcus luteus.
Break
a fresh, dry, hard clove from a bulb of garlic and peel off the paper-like
cover. Cut in half. A whole clove will
NOT work. A crushed clove releases more
allicin, but is harder to insert. Tie very
tightly (so it cuts a bit into the garlic) a piece of white thread and leave
the thread hanging out, as if it was a tampon thread. That way it can easily be
removed with very little effort. Putting the clove in gauze will prevent direct
contact and decrease effectiveness. Put damaged garlic clove in your
vagina in the evening before you go to sleep. Many women taste garlic in their
mouths as soon as it is in their vagina- so it is less pleasant to treat while
awake. You can grind up garlic and
insert the mush. This would have the
most effectiveness because it increases is the dosage the more surface area of
the garlic is exposed. You can put it on the end of a tampon for example. In
the morning, the garlic may come out when you poop. If not, many women find it
is easiest to take it out on the toilet. Circle the vagina with a finger, till
you find it. It cannot enter the uterus through the cervix. It cannot get lost-
but it can get pushed into the pocket between the cervix and the vaginal wall.
Most people will taste the garlic as long as it is in there. So if you still
taste it, it is probably still in there. Most women have trouble getting it out
the first time.
For
easy retrieval sew a string through the middle of the clove before you put it
in- You don’t want to get irritated in the process of getting rid of the GBS.
Be gentle. Don’t scratch yourself with long nails. Repeat this for 8 nights (around week 36). Or
for 2 nights on, 1 night off, for 5 times (8 nights in 15 days)
After
the eight night of treatment, get cultured at the health care place you go to.
Before you go to get the culture, wash perineum and rectal area with soap and
put on clean cotton underwear. GBS
usually lives in your large intestine, and from there contaminates the vagina. A Rectal/Vaginal culture is done with a
cotton swab inserted into the vagina and then into the anus.
How often do you find that this remedy is
effective? I tell my clients to go ahead and try it if
they chose to test at all and really want to be sure that they
are negative. Some do and some do not. It is a new option. The more they do the
more evidence I will have to give. Currently there is no funding for this
natural remedy option so there are very few studies to see. (9)
Does
raw garlic tend to cause irritation of the vagina?
Not usually but women say they can taste it
while they have it in the vagina. They can also try some oral garlic or other
ways to boost immune system. I have all my moms take probiotics to keep healthy
flora first off.
Is
there a way to prevent this or an alternative treatment? Oh
So Many….
Ideally,
you will begin treatment at about 32 weeks, on confirmation of the presence of
beta-strep in a vaginal culture, a urine sample that showed beta-strep, or a
rectal sample. (Some doctors will do both a vaginal and rectal swab.) Treatment
will include taking herbs orally that strengthen your immune system and
applying herbs vaginally that will restore your healthy vaginal flora, that
will enable your body to reduce bacterial overgrowth, and also that will
directly fight the bacteria. As you enter the last few weeks of pregnancy, from
37 weeks onward (since your baby is unlikely to be premature), most midwives
will be willing to assist you at home if this is your plan. In the hospital,
your baby will also be considered close to full term and will not be treated as
premature in most circumstances. At 37 weeks, you can therefore begin to use
certain herbs both orally and vaginally that are sometimes considered labor
stimulants, but are nonetheless effective for reducing bacterial infections.
At
32 weeks, begin to take a supplement of 500 mg of vitamin C, and 1 cup of
burdock root and echinacea root infusion. To prepare the infusion, steep 1/2
ounce of each of these herbs in 4 cups of boiling water for 2 hours. Strain and
take the above dose, storing the rest in the refrigerator for the next day.
Eat
a lot of fresh garlic every day.
Take
1/2 teaspoon each of echinacea and astragalus tinctures twice daily. You can
also get dried astragalus in the herb department of your health food store and
cook two strips into a pot of rice or soup two to three times per week. Remove
the strips when done cooking and eat the rice or soup. Astragalus is an immune
system tonic well known in the Chinese pharmacopoeia, but also grows in
America.
Garlic Remedies
Chop a clove of fresh garlic and mix with a teaspoon of honey. Swallow this
without chewing it. This can be done several times a day, preferably with a
meal.
Make
a garlic elixir by blending 1/2 cup of honey, 1/4 cup of apple cider vinegar,
and half a bulb of fresh garlic in your blender until liquidy. Take 1/2
teaspoon up to twice a day. Adjust the taste as necessary with more or less of
the honey or vinegar. Chop fresh garlic onto a salad, or mix with olive oil to
use as a dressing or dip French bread into this as a condiment.
Take
garlic pearls according to the dosage on the brand you purchase.
If
garlic doesn't work, there are other options to consider:
Tea tree oil 2% oil to 98% olive oil soaked
tampon. Place tampon in vagina for 4 hours daily times 1 week, then retest for
GBS.
Rinse your vaginal area every six hours for one
week before your GBS test with a chlorhexidine wash (which can be purchased
from your local drug store under the brand name Hibiclens), diluted as four
tablespoons Hibiclens to 2 ¼ cups water. I put a bottle in each birth kit and
rarely need it.
“Other practitioners of herbal remedies and
supplements have found GREAT success rates of the following strict regime to
eradicate GBS from their bodies all together: a daily regiment of douches and
oral remedies. Oral acidophilus and a grapefruit seed extract douche in the
morning. Garlic capsules inserted vaginally in the afternoon. And an oral once
a day garlic capsule in the afternoon. Finally a goldenseal root powder douche
at night along with another oral acidophilus.” (7)
Constance Rock LM Protocol:
The following treatment plan is designed to
boost your immune system. For most women, this helps reduce or even eliminate
the growth of Group Beta Strep. We’ve
had excellent results with this protocol. Nearly all of our clients who have
cultured positive at 36 weeks have been able to completely eliminate the GBS by
the time they delivered. Some clients have only been able to minimize the
growth, but the large dose of vitamin C causes their amniotic sack to thicken,
thus preventing the bag from rupturing until they’re pushing which
significantly reduces the baby’s time of exposure and the likelihood of
infection. For those women who test positive, we recommend culturing once a
week until delivery so we can see the positive effect the protocol is having.
Twice a day, with breakfast and dinner:
- Acidophilus – 4 billion cells per dose
- Echinacea – 350 mg capsules – 2 capsules
- Garlic – 580 mg capsules – 2 capsules (you may also
- Vitamin C – 1000 mg with 200 mg bioflavonoids
- Grapefruit Seed Extract – 15 drops
- Zinc 50mg a day
- Also douche with wheatgrass
2x per week
- Insert plain yogurt
vaginally 2x week
- Colloidal Silver, 1 dropper
a day, low dose
If you are successful at eliminating the Group
Beta Strep, we suggest continuing the treatment until your baby is born to give
yourself the best possible chance that the bacteria will not be present at the
time of birth.
References:
- Chen, H.C., Chang,
M.D., Chang, T.J. (1985) Antibacterial Properties of Some Spice Plants
Before and After Heat Treatment. [English translation of Chinese
article]. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 18:
190–5.
- Klein, J.O. (1999)
Management of Acute Otitis Media in an Era of Increasing Antibiotic
Resistance. Int J Pediatr Otorhinolaryngol 49: S15–17.
- Honig, E., Mouton
J.W., van der Meijden, W.I. (1999) Can Group B Streptococci Cause
Symptomatic Vaginitis? Infect Dis Obstet Gynecol 7:
206–09.
- Christensen, K.K,
Dykes, A.K., Christensen, P. (1985) Reduced Colonization of Newborns with
Group B Streptococci Following Washing of the Birth Canal with
Chlorhexidine. J Perinat Med 13: 239–43.
- Irving, W.L. Best
Practice in Labour Ward Management. Edited by L.H. Kean, P.N. Baker
and D. Edelstone. London: WB Saunders, 2000.
- Albandar, J.M.,
Gjermo, P., Preus, H.R. (1994) Chlorhexidine Use after Two Decades of
Over-the-counter Availability. J Periodontol 65: 109–12.
- http://wonderfullymadebelliesandbabies.blogspot.com/2007/08/gbs-giant-bothersome-stumblingblock.html
- http://www.americanpregnancy.org/pregnancycomplications/groupbstrepinfection.html
- http://www.ncbi.nlm.nih.gov/pubmed/15651446
