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Group B Streptococcus prophylaxis — MCCQE Part 1 MCQ

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EasyPregnancyGroup B Streptococcus prophylaxisMCCQE Part 1

26-year-old woman in labour presents with regular contractions at 39 weeks. Her rectovaginal culture at 36 weeks was positive for group B Streptococcus. Which of the following is the most appropriate next step?

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Correct answer: C — Give intrapartum IV antibiotic prophylaxis

Give intrapartum IV antibiotic prophylaxis is best because positive GBS screening culture indicates intrapartum prophylaxis. Discharge without pregnancy-specific safety-netting is suboptimal because pregnancy-related bleeding, pain or hypertension can deteriorate quickly; Perform a digital vaginal examination before excluding placenta previa or instability is suboptimal because digital examination can precipitate haemorrhage when placenta previa is possible; Use a medication contraindicated in pregnancy as first-line therapy is suboptimal because maternal treatment must account for fetal safety and gestational age; Delay obstetric or gynaecologic consultation despite red flags is suboptimal because specialist involvement is needed when maternal or fetal risk is present. The goal is prevention of early-onset neonatal GBS disease.

Reference: SOGC GBS guideline