Group B strep test

Most of this post is copied and pasted from other places. I've put all my comments in italics. I'm still undecided whether I will have the test or not.

About 40% of adults are carriers of Group B Streptococcum (GBS) in their genital or intestinal tracts. Usually, GBS doesn't cause problems. In fact, in most healthy adults it is considered a "normal" organism, and treatment with antibiotics is not given. It does have significance for the pregnant woman, however. GBS, which can be passed from mother to baby during childbirth, is the leading cause of newborn sepsis--serious infection throughout the baby's body soon after birth.
A specific combination of factors seems to be at work in babies who develop GBS disease. It is most likely to develop in babies whose mothers are carriers of GBS and who have one or more clinical risk factors. In these babies, who are at the highest possible risk for GBS disease, about five out of 100 will develop it. Babies whose mothers are GBS carriers but have no clinical risk factors are less likely to develop GBS disease: about one in 200 babies will get GBS disease. Those whose mothers have clinical risk factors but test negative for GBS are even less likely to develop GBS disease--about 1 in 1000--and those whose mothers have neither risk factors nor a positive GBS culture have a very small chance of getting GBS disease--about 1 in 3000.
Clinical Risk Factors for Developing GBS Disease:Prenatal risk factors: Previous baby with GBS disease; urinary tract infection with GBS at any time during this pregnancyLabor-related risk factors: Onset of labor before 37 weeks, rupture of membranes before 37 weeks; rupture of membranes more than 18 hours before birth; fever over 100.4 degrees during labor.
Researchers conducted a review of infants who had early-onset group B streptococcal (EOGBS) infections and were born in Southern California Kaiser Permanente Hospitals from 1988 through 1996. To summarize:
*319 infants with EOGBS sepsis, bacteremia, or clinically suspected infection were identified from a population of 277,912 live births (approximately 1 in every 870 births).*Of the 172 term infants with culture-positive infection who had clinical signs of infection, 95% exhibited them in the first 24 hours of life.*All of the infants exposed to antibiotics during birth became ill within the first 24 hours of life.
Researchers concluded that "exposure to antibiotics during labor did not change the clinical spectrum of disease or the onset of clinical signs of infection within 24 hours of birth for term infants with EOGBS infection."
(from http://www.midwiferytoday.com/enews/enews0337.asp )

Because women who carry GBS but do not develop any of these three complications have a relatively low risk of delivering an infant with GBS disease, the decision to take antibiotics during labor should balance risks and benefits. Penicillin is very effective at preventing GBS disease in the newborn and is generally safe. A GBS carrier with none of the conditions above has the following risks:
* 1 in 200 chance of delivering a baby with GBS disease if antibiotics are not given
* 1 in 4000 chance of delivering a baby with GBS disease if antibiotics are given
* 1 in 10 chance, or lower, of experiencing a mild allergic reaction to penicillin (such as rash)
* 1 in 10, 000 chance of developing a severe allergic reaction--anaphylaxis--to penicillin. Anaphylaxis requires emergency treatment and can be life-threatening.

the bacteria can come and go, so the test isn't always a reliable indicator of who will have GBS on delivery day. And since results aren't available for a few days, testing during labor isn't possible. (*Why do it if you are not sure if the results will still be acurate?)
Some doctors only screen patients who have a history of urinary tract infections, a fever near delivery time, or who have had a GBS baby. (*I have none of these things*)
GBS is easily treated with antibiotics, so call your doctor if your baby has symptoms such as uncontrollable crying, poor feeding, fever, grunting, or blue skin. (Late-onset GBS, which develops after the first week, may also cause vomiting.)

Apparently you can test positive, but then do it again later and be negative. I don't think the test is very reliable. However, I don't want anything to happen to the poor innocent raisin either.

If I get nervous

I have found that when I start feeling nervous about labor or taking care of the new baby that all I have to do is read some blogs. That's right! Read blogs. I have a few favorites at Babes in Blogland that I read regularly, and some that I read periodically. Seems like everyone has the same fears/concerns/worries that I do. That makes me feel better!

We had another appointment today at the Birth Center. She measured me and took my blood pressure and such, the usual things. Everything was normal. The raisin's heartbeat was normal. She felt around and found out that he is in the head down position now, with his back along my left side. That explains why almost all the movement is on my right...he's got arms and legs flailing over there! The midwife (who was very nice and informative, as I will discuss later) said that is the best position for him to be in for the easiest birth. Hooray! The raisin is already smart!

I asked the (very helpful, informative) midwife about the achy/crampy feeling I've been having lately. First let me tell you, it is very hard to explain what it feels like...it's not like "the cramps" but it's like the feeling I get the few days before my period starts, like pre-cramps...anyway, it happened every night for a few days so I was worried. She said that as long as it isn't intermitent cramps then I should be ok. So as long as it stays a constant ache then it's normal. Also, I do some labwork every appointment. I have to pee in a cup and swish this little paper sticky thing around in it and then record the results. Anyway, for the last 3 appointments I've had elevated leukocytes. I asked about this, because it doesn't seem normal to me. She asked if I had any pain or burning when I pee, to which I answered (honestly) that no I didn't. She then said that sometimes the elevated leukocytes are a sign of a bladder infection, but if there were no symptoms then it was probably just a contaminated sample or some such thing and not to worry.

She said that sometime in the next 2 weeks I need to decide if I want to have the Strep B test. She said that it will find out if there are nasty little bacteria waiting to attack the raisin when he comes out. If you do have it then they give you antibiotics while you are in labor, which SHOULD prevent anything happening to the baby. She also said that if the test is positive then I won't be able to have the baby at the birth center. It isn't a required test, so I'm not sure if I will do it yet. Apparently the results of the infection if the baby does pick it up are quite serious, but only a few women carry it (10 - 30%), and only .5% of them have babies who get the infection. It sounds like a super small percentage to me, but I'm going to do plenty of research before I decide one way or the other.