When expecting a baby, any illness can cause worry, including strep throat. Strep throat is a bacterial infection caused by Group A Streptococcus (GAS). While pregnancy does not increase the risk of contracting this infection, a diagnosis requires immediate medical attention and treatment. Consulting with a healthcare provider is the necessary first step to ensure both your and your baby’s health.
Recognizing the Symptoms and Getting Tested
Strep throat symptoms often appear suddenly and are distinct from a common cold, which usually develops gradually. The primary indicator is a severe, painful sore throat that makes swallowing difficult. Unlike a cold, strep throat typically presents without a cough, runny nose, or congestion.
Other characteristic signs include a fever of 100.4°F or higher and tiny red spots on the roof of the mouth, known as petechiae. You may also notice swollen, tender lymph nodes in the neck and white patches or streaks of pus on the tonsils. If these symptoms appear, contact a healthcare provider for confirmation.
Diagnosis involves a throat swab used for either a Rapid Antigen Detection Test (RADT) or a throat culture. The RADT provides quick results but is not always accurate. Due to the importance of treating strep during pregnancy, a negative RADT result should often be followed up with a throat culture, which is more accurate but takes 24 to 48 hours to process.
Why Prompt Treatment is Essential During Pregnancy
Untreated strep throat can lead to severe health complications, and this risk is amplified during pregnancy. Maternal complications include acute rheumatic fever, which can permanently damage the heart valves, and post-streptococcal glomerulonephritis, involving kidney inflammation.
While the strep infection rarely harms the developing fetus, a sustained high fever is a concern, particularly in the first trimester. A high fever places stress on the pregnant individual’s body. Starting antibiotics quickly helps lower the fever and prevents the infection from progressing to a systemic state.
Timely treatment also eradicates the bacteria from the pharynx before delivery. This prevents the possibility of the newborn becoming infected with Group A Strep, which poses a serious health risk to the baby.
Safe and Effective Treatment Options
Antibiotic therapy is required to treat Group A Strep infection and prevent serious complications like rheumatic fever. Penicillin and amoxicillin are the first-line treatments recommended for pregnant patients, as they are considered safe during all trimesters. Both medications are classified as Pregnancy Category B and have a long history of safe use in human pregnancy.
The standard course of treatment is a full 10 days, and it is crucial to complete the entire prescription even if symptoms resolve earlier. Stopping prematurely risks incomplete bacterial eradication, which can lead to recurrence or complications. For patients with a non-severe penicillin allergy, first-generation cephalosporins, such as cephalexin, are recommended as safe alternatives.
For individuals with a severe allergy to penicillin, a macrolide or clindamycin may be used, though cephalosporins are generally preferred. It is important to be aware of antibiotics avoided during pregnancy due to potential fetal risks. These include tetracyclines, which can cause tooth discoloration, and fluoroquinolones, associated with potential cartilage damage.
Managing Symptoms and Preventing Spread
While antibiotics clear the infection, supportive care can ease the discomfort of strep throat symptoms. Over-the-counter pain relief is generally limited to acetaminophen (Tylenol), which is considered safe during pregnancy when taken at the recommended dose. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are typically avoided, especially later in pregnancy.
Local relief measures can soothe the painful throat. These include gargling with warm salt water several times a day and sipping on warm liquids, such as herbal teas or broth, to stay hydrated. Using a cool-mist humidifier at night can also help moisten the air and ease throat irritation.
To prevent spreading the infection, stringent hygiene practices are necessary. This includes frequent handwashing, particularly after coughing or sneezing. Avoid sharing eating utensils, drinking glasses, and food with others. You are generally considered non-contagious and safe to return to normal activity 24 hours after starting the antibiotic treatment and if your fever has resolved.