# Strep B and elective c-section?



## emms (Feb 6, 2006)

Hiya,

I really hope you might be able to give me some advice, I apologise this may be a little long  


We lost our twin boys back in March 2007 at 18+4 weeks, we never had a definite reason for their early birth, but it looks like the most likely cause was my Strep B crossing the membranes and infecting the Placenta and possibly the babies too, This caused me to labour early. The lab tests afterwards came back saying the placenta was infected. And I also had a very raised temperature during labour suggesting the Strep B was present.

During this pregnancy I have been having 2 weekly scans on my cervix to check for shortening, which have all proved fine, and I have been on penicillin approx every 2-3 weeks at my consultants request, although this is not usual practice for carriers of Strep B, due to my history she wants to do all she can to try and help. I have recently finished a solid 4 week course of penicillin taken from 20 weeks to 24 weeks, to reach to the point of viability. 

I am currently 26 weeks pregnant which for us is such a major milestone, and my consultant has said that as we are now at a stage of viability no more penicillin unless I feel any symptoms myself, which is fine we are happy with that however this is where I am hoping you could give me some advice? 

I am at risk of having another preterm delivery due to my history, which if this were to happen will be managed accordingly, either by allowing the labour to progress if baby and me are fine, or by doing an emergency c section if the baby shows signs of distress or I get a temperature or symptoms. Penicillin will be administered throughout labour. 

The question that my husband and I have is if this little one stays cooking for the duration, do we not have good grounds to request an elective section? we are really worried that if I am left to labour on my own it may happen too quick and I don't get enough penicillin to protect our baby, or labour goes on too long particularly if the waters are broken for more than 6 hours, meaning baby is at greater risk of being exposed to strep B, and also meaning that I myself am at greater risk of contracting problems from the Strep B. 

The other concern I have is that during any internal examination the Strep B can be introduced to the uterus via the vagina, so if I labour naturally i would presume that each time I am being checked the risk of Strep being introduced is going up. 

What I am trying to say is that do you think I have good grounds to request an elective section based upon all these concerns? I am not afraid of labouring naturally, but what I want to avoid is stressfull situations during an already tense time, and after all that ending up going for an emergency section which my consultant said could happen if baby is distressed, i get a temp or they are generally not happy with something. 

My husband and I feel much happier knowing everything is  going to be calm and collected and under control, all we want is for our little girl to be born safely, and the only way we can see that happening is by having an elective C section, I know there are risks to think about with any section, and we have thought about this. Do you think it would be a reasonable request?

I'm sorry to have garbled on so long I just wanted to put across all the facts, I really hope you can help.

Regards

Emma.


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## emilycaitlin (Mar 7, 2006)

Hi,

Have you got Strep B this time?  If not, I wouldn't be too concerned about labouring this time, as the antibiotics would just be an extra extra precaution.  Also, examinations wouldn't pose a risk of strep B, although the more you have, the more risk of getting a general infection there is.  If you do have Strep B this time, you would normally be fine to labour, however, I can completely understand that with your history, you would feel safer having an elective section, and I would think your consultant would understand that.

let me know how you get on,

emilycaitlin xx


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## emms (Feb 6, 2006)

hiya,

Thanks for your reply Emilycaitlin  

Yes I do have Strep B this time too, i was tested at 6 weeks, and they found it, the consultant was concerned about it and grew on the bacteria in the lab, and said it was a particularly bad strain of it, so he gave me antibiotics for 1 week. 

I have been tested every 2-3 weeks for it since then by my lady obstetrician (in her preterm loss clinic), and it has been present each time, never going away, and each time they have grown the bacteria on and given me antibiotics to best suit the strain at the time. I have not been tested for the last few weeks, as we are now presuming that it will be there and wont shift, and now baby is at a viable stage she doesn't want to give any more treatment encase I become resistant and it wont protect baby when its needed. 

We are just so concerned about it, Strep B is a normal bacteria present in many women, and never causes a problem, but with us it caused the loss of our boys, we just cant bear the thought of exposing our precious little girl to it for even a second. I am paranoid enough about handling her when she is born, as I know its possible for you to pass on strep B that way, also I have decided not to breast feed as I am terrified that she will get it that way, and that she will get ill and it will be me to blame, unlikely I know but i cant help thinking it, I just cant bear to put our little baby at risk.

Our consultant has said there is not really any need for an elective section, they will try and manage labour as best they can, but erring on the side of caution, I am sure as you say she will understand our concerns if we do push for an elective section, i know its not the easy way out, but we just want to protect our baby. 

Thankyou for your help, once again you are a star, I will discuss this again on my next appointment and see what she says. 

Regards

Emma x


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