Strep refers to bacterial infections caused by various types of Streptococcus bacteria. While some strep infections are common and often mild, certain types can present specific concerns during pregnancy. Prompt identification and appropriate management of these infections are crucial for the health of both the pregnant individual and the developing baby.
Types of Strep Relevant to Pregnancy
Two primary types of Streptococcus bacteria are particularly relevant during pregnancy: Group A Streptococcus (GAS) and Group B Streptococcus (GBS). Group A Strep (Streptococcus pyogenes) is commonly associated with conditions like strep throat and certain skin infections. While typically causing mild illness, GAS can lead to more severe complications in some cases.
Group B Strep, or Streptococcus agalactiae, frequently colonizes the gastrointestinal and genitourinary tracts of many healthy adults, including an estimated 20% to 40% of pregnant individuals. Most individuals carrying GBS experience no symptoms and are unaware of its presence. This colonization, however, poses a risk of transmission to the newborn during vaginal delivery.
Recognizing Symptoms and When to Seek Care
For Group A Strep, common indicators include a sudden and painful sore throat, fever, and red or swollen tonsils which may have white spots or streaks. Other signs can involve difficulty swallowing, headache, and swollen, tender lymph nodes in the neck.
These symptoms typically appear within two to five days after exposure. While many sore throats are caused by viruses, the presence of a sore throat accompanied by fever warrants medical attention. A high fever, particularly during the first trimester, can be a concern for fetal organ development, requiring prompt medical consultation.
Diagnosis and Treatment During Pregnancy
Diagnosing strep infections during pregnancy involves specific tests to identify the bacteria. For suspected Group A Strep, a rapid strep test or a throat culture is typically performed. These tests help confirm the presence of Streptococcus pyogenes.
For Group B Strep, routine screening is conducted between 36 and 37 weeks of pregnancy. This involves a simple and painless swab of the vagina and rectum, which is then sent to a laboratory for culture to detect GBS colonization. If GBS is detected, antibiotics are the standard treatment. Penicillin and amoxicillin are commonly prescribed and are considered safe for use throughout pregnancy. For GBS-positive individuals, intravenous antibiotics are administered during labor to prevent transmission to the newborn. Ideally, these antibiotics are given at least four hours before delivery to be most effective.
Impact on Mother and Baby
Untreated strep infections during pregnancy can lead to various complications for both the pregnant individual and the baby. If Group A Strep goes untreated, it can potentially result in conditions such as rheumatic fever or kidney inflammation. In more severe instances, invasive Group A Strep can cause serious infections like sepsis, pneumonia, meningitis, or an infection of the uterus after birth, known as postpartum endometritis.
Group B Strep can cause several issues for the pregnant individual, including urinary tract infections, infection of the amniotic fluid and membranes (chorioamnionitis), and postpartum endometritis. It may also be associated with preterm labor, preterm premature rupture of membranes, or, in rare cases, stillbirth.
The primary concern with GBS, however, is its potential transmission to the newborn during labor and delivery. This transmission can lead to serious conditions in the baby, particularly early-onset disease, which manifests within the first seven days of life, often within 24 hours of birth. These conditions include sepsis (a bloodstream infection), pneumonia (a lung infection), and meningitis (an infection of the brain and spinal cord lining).
While less common, late-onset GBS disease can develop between seven days and three months of age, potentially causing similar issues. Meningitis in newborns, regardless of onset, can lead to long-term consequences such as hearing loss, vision loss, learning disabilities, seizures, and cerebral palsy. Preterm babies face an increased susceptibility to GBS infection.
Preventive Measures and Screening
Several measures can help reduce the risk of strep infections during pregnancy. Maintaining good hygiene practices, such as frequent handwashing with soap and water, helps prevent the spread of various bacteria. Avoiding the sharing of eating utensils, drinks, and other personal items can also help minimize exposure.
For Group B Strep, a universal screening protocol is in place for pregnant individuals. This involves a vaginal and rectal swab performed between 36 and 37 weeks of gestation. The purpose of this screening is to identify individuals who are colonized with GBS so that preventive intravenous antibiotics can be administered during labor.