A diagnosis of strep throat during pregnancy, caused by the bacterium Group A Streptococcus (GAS), requires immediate attention and treatment. Although this infection is common and usually mild in non-pregnant adults, the physiological changes and suppressed immune function of pregnancy elevate the stakes. Prompt medical consultation is necessary because an untreated bacterial infection can potentially lead to serious complications for the pregnant person and the developing fetus.
Immediate Steps for Diagnosis and Consultation
If symptoms such as a sudden sore throat, pain when swallowing, fever, or white spots on the tonsils appear, the first step is to contact your obstetrician-gynecologist or midwife immediately. This consultation is paramount because a provider familiar with your pregnancy history can best determine the safest and most appropriate diagnostic and treatment plan. Do not rely solely on an urgent care center without first alerting your dedicated pregnancy care team.
Diagnosis typically involves a rapid strep test, where a cotton swab collects a sample from the back of the throat, providing results within minutes. If the rapid test is negative, a throat culture is often sent to a laboratory for confirmation, especially for pregnant individuals, as the culture is more sensitive. Treatment with antibiotics can begin immediately after a positive test to minimize the time the infection remains active.
Risks of Untreated Strep Throat During Pregnancy
Treating strep throat is mandatory in pregnancy primarily to prevent the infection from progressing to a more invasive disease state. Untreated Group A Streptococcus infection can cause serious systemic complications for the pregnant person, including acute rheumatic fever, a condition that affects the heart, joints, brain, and skin. It can also lead to post-streptococcal glomerulonephritis, a form of kidney damage resulting from an immune reaction to the bacteria.
The greatest concern is the possibility of the infection becoming invasive Group A Streptococcus (iGAS), which can lead to life-threatening conditions like sepsis and toxic shock syndrome. While a direct, causal link between uncomplicated strep throat and adverse fetal outcomes is not definitively established, any severe systemic infection accompanied by a high fever increases stress on the pregnancy. High fever alone can pose risks to the developing fetus, particularly during the first trimester.
Safe Antibiotic Treatment Protocols
Antibiotics are the only effective intervention for strep throat, as it is a bacterial infection, and they are considered safe and necessary during pregnancy. Penicillin and amoxicillin are the first-line choices for treatment because they have a long history of safety and are classified as Pregnancy Category B drugs. This classification indicates that animal studies have not shown harm, and no controlled studies in pregnant women have demonstrated risk.
The standard course of treatment for strep throat is a ten-day regimen of antibiotics, which is crucial for completely eradicating the bacteria and preventing complications like rheumatic fever. It is important to complete the entire course of medication, even if symptoms begin to improve after the first few days. Stopping the antibiotics prematurely increases the risk of the infection recurring or developing resistance to the drug.
For individuals with a known penicillin allergy, alternatives such as certain first-generation cephalosporins (like cephalexin) are prescribed. If the allergy is severe or anaphylactic, your provider will select a different class of antibiotic, such as a macrolide or clindamycin, while considering the potential for regional bacterial resistance.
Supportive Care and Non-Medication Relief
While antibiotics work to clear the infection, several non-pharmacological methods can provide relief from the uncomfortable symptoms of strep throat. Maintaining adequate hydration is important for managing fever and keeping the throat moist, with warm teas and plain water being good choices. Using a humidifier in the bedroom can help soothe throat irritation by adding moisture to the air.
Gargling several times a day with warm salt water can temporarily relieve throat soreness. A simple solution of one-quarter teaspoon of salt dissolved in eight ounces of warm water is effective and safe. Throat lozenges are generally safe and can help stimulate saliva production, which lubricates the throat.
Rest is also a key factor in recovery, allowing the body’s immune system to focus its energy on fighting the infection. Before taking any over-the-counter pain relievers, cold medications, or fever reducers, it is imperative to consult with your pregnancy care provider. Some common pain relievers, specifically nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin, are not recommended during certain stages of pregnancy and must be avoided unless explicitly directed by your doctor.