Group B streptococcal (GBS) disease screening and treatment during pregnancy: nurse-midwives' consistency with 1996 CDC recommendations.
OBJECTIVE
In 1998, the screening and treatment practices of certified nurse-midwives (CNMs) for group B streptococcal (GBS) infection during pregnancy were studied and evaluated for their consistency with the 1996 perinatal GBS prevention guidelines of the Centers for Disease Control and Prevention (CDC).


METHODS
Five hundred thirty-nine surveys were completed by CNMs attending the 1998 American College of Nurse-Midwives' Convention. Of these, 502 (94.7%) reported a practice policy for GBS prophylaxis.


RESULTS
The Culture-Based Approach was used by 66.7% and the Obstetrical Risk Factor Approach by 28%. Most (69%) reported using multiple culture sites, most commonly the proximal vagina and anorectal area (33.2%), followed by the distal vagina and anorectal area (26.7%), and the anorectal area and proximal and distal vagina (7.1%). Most CNMs (92.5%) reported treating GBS intrapartally, with penicillin the most frequently reported antimicrobial (55.0%) used, and most (94.2%) reporting treatment through labor until birth.


CONCLUSIONS
Overall, GBS prophylaxis practices among survey respondents comply with 1996 CDC recommendations; however, GBS screening practices show room for improvement and the need for continuing education that emphasizes the CDC guidelines, updates as they become available, and other new literature about the topic. In addition, heightened awareness among all perinatal providers is needed with respect to CDC guidelines, especially as they pertain to variations in culture sites, identification of risk categories, and the selection of appropriate antimicrobial treatment agents.
Bloom
K C
KC
College of Health, Department of Nursing at the University of North Florida in Jacksonville, USA.
Ewing
C A
CA
D002487:Centers for Disease Control and Prevention, U.S.; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008403:Mass Screening / Q000592:standards; D009721:Nurse Midwives / Q000592:standards*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D011295:Prenatal Care / Q000592:standards*; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D013292:Streptococcus agalactiae; D014481:United States