Tag Archive | GBS

What to Do When your Bag of Waters Breaks

It is common to be in labor without your water breaking. Actually, only thirty percent of women experience their water breaking before the start of labor.

What Is My Bag of Waters?

The bag of waters—or amniotic sac—is a bag or “membrane filled with fluid that surrounds your baby in your uterus during pregnancy.” The bag of waters is very important to your baby’s health. The fluid protects your baby and gives your baby room to move around. The bag itself protects your baby from infections that may get into your vagina.

Is it urine or is it amniotic fluid? If you are leaking, it can be difficult to determine if your membranes are leaking or if it is urine. In most cases, it is probably urine. There are several ways to tell the difference, but there is no definite answer. When in doubt, smell it! Urine has a distinct smell and color. You will leak urine when your bladder is full, when coughing , sneezing or laughing; even when you are exercising. Only 3 percent of pregnant women will go into premature labor (before 37 weeks) as a result of ruptured membranes.

In most cases your membranes will rupture as you are nearing the end of your pregnancy, and this is definitely one of the early signs of labor. If your water does break in public, and you have visions of a huge gush of water running all over the floor, then you have probably been watching too many movies. It is most likely going to occur as a slow trickle, or at most, a small gush of fluid of colorless and odorless amniotic fluid. Call your healthcare provider if your water breaks and the fluid is green or brown. This is an indication that your baby had a bowel movement in utero.

What Should You Do When Your Water Breaks

First, don’t panic! Follow the instructions your healthcare provider discussed with you if and when your water breaks. Immediately after your water breaks, know that nothing should be placed in your vagina at this point. This will help prevent infection.
•Wear a maxi pads, not tampons, to keep the amniotic fluid from wetting your clothes
Keep your vaginal area clean
When you go to the bathroom, be sure to wipe from front to back
Sexual intercourse is officially off-limits

Call your healthcare Provider immediately if:

Your due date is more than 3 weeks away from today
•The water is green, or yellow, or brown, or has a bad smell
•You have a history of genital herpes, whether or not you have any herpes sores right now
•You have a history of Group B strep infection (“GBS positive”)
•You don’t know if you have GBS or not
•Your baby is not in the head-down position, or you’ve been told it is very high in your pelvis
•You have had a very quick labor in the past, or feel rectal pressure now
•You are worried.
•If you feel something in your vagina, or see any of the umbilical cord at the vaginal opening, get medical help immediately

Call your health care provider within a few hours if:
•Your due date is within the next 3 weeks and
• You are not in labor and the fluid is clear, pink, or has white flecks in it
• Your baby is in the head-down position
•Some health care providers will want you to come in to the office to confirm that the bag of waters has broken and listen to the baby’s heartbeat as soon as you notice that the bag of waters has broken. Others will suggest you stay home for several hours to wait for labor to start.

What Do I Do Until Labor Starts?

Most women will go into labor within 48 hours. If you are waiting for labor to start and your bag of waters has broken:
• Put on a clean pad
•Do not put anything in your vagina
•Drink plenty of liquids—a cup of water or juice each hour you are awake
•Get some rest
•Take a shower
•If there is any change in your baby’s movements, call your health care provider right away

Check your temperature with a thermometer every 4 hours—call right away if your temperature goes above 99.6.

For more information regarding this topic visit:

http://www.acnm.org

http://www.webmd.com

Group B Strep in Pregnancy: Frequently Asked Questions

1. What is Group B Strep (GBS)?
GBS is one of many common bacteria that live in the human body without causing harm in healthy people. GBS develops in the intestine from time-to-time, so sometimes it is present and sometimes it is not. Group B Strep or GBS can be found in the intestine, rectum, and vagina in about 2 of every 10 pregnant women near the time of birth. GBS is NOT a sexually transmitted disease, and it does not cause discharge, or itching. Unfortunately, it can cause a bladder/urinary tract infection.

2. How Does GBS Cause Infection?
At the time of birth, babies are exposed to the GBS bacteria if it is present in the vagina, which can result in pneumonia or a blood infection. Full-term babies who are born to moms who carry GBS in the vagina at the time of birth have a 1 in 200 chance of getting sick from GBS during the first few days after being born. Occasionally, moms can also get a postpartum infection in the uterus.

3. How Do You Know if You Have GBS?
Around your 35th to 36th week, during a regular prenatal visit, your healthcare provider will collect a sample by touching the outer part of your vagina and just inside the anus with a sterile Q-tip. If GBS grows in the culture that is sent to the lab from that Q-tip sample, your provider will make a note in your chart, and you will be notified at your next prenatal visit that you are GBS positive, The GBS protocol for a positive culture will be discussed at your next visit with your healthcare provider and the expectations of care when you are in labor.

4. How Can Infection from GBS Be Prevented if My Culture is Positive?
If your GBS culture is positive within 4 to 5 weeks before you give birth, your healthcare provider will recommend that you receive antibiotics during labor. GBS is very sensitive to antibiotics (penicillin or penicillin family) and is easily removed from the vagina. A few intravenous doses given up to 4 hours before birth almost always prevents your baby from picking up the bacteria during the birth. It is important to remember that GBS is typically not harmful to you or your baby before you are in labor.

5. Do You Have to Wait for Labor to Take the Antibiotics?
Although GBS is easy to remove from the vagina, it is not easy to remove from the intestine where it lives normally and without harm to you. Although GBS is not dangerous to you or your baby before birth, if you take antibiotics before you are in labor, GBS will return to the vagina from the intestine, as soon as you stop taking the medication. Therefore, it is best to take penicillin during labor when it can best help you and your baby. The one exception is that, occasionally, GBS can cause a urinary tract infection during pregnancy. If you get a urinary tract infection, it should be treated at the time it is diagnosed, and then you should receive antibiotics again when you are in labor.

6. How Will We Know if Your Baby Is Infected?
Babies who get sick from infection with GBS almost always do so in the first 24 hours after birth. Symptoms include difficulty with breathing (including grunting or having poor color), problems maintaining temperature (too cold or too hot), or extreme sleepiness that interferes with nursing.

7. What Is the Treatment for a Baby with GBS Infection?
If the infection is caught early and your baby is full-term, most babies will completely recover with intravenous antibiotic treatment. Of the babies who get sick, about one in six can have serious complications. Some very seriously ill babies will die. In the large majority of cases if you carry GBS in the vagina at the time of birth and if you are given intravenous antibiotics in labor, the risk of your baby getting sick is 1 in 4,000.

8. What If You Are Allergic to Penicillin?
Penicillin or a penicillin-type medication is the antibiotic recommended for preventing GBS infection. Women who carry GBS at the time of birth and who are allergic to penicillin can receive different antibiotics during labor. Be sure to tell your healthcare provider if you are allergic to penicillin and what symptoms you had when you got that allergic reaction. If your penicillin allergy is mild, you will be offered one type of antibiotic, and if it is severe, you will be offered a different one.

Provided by Angel J. Miller, MSN, CNM