title: Antepartum Membrane Stripping in GBS Carriers, Is It Safe? (The STRIP-G Study).
abstract: OBJECTIVE
  Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. We conducted 'the STRIP-G study' in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping.
  
  
  METHODS
  We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.
  
  
  RESULTS
  A total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).
  
  
  CONCLUSIONS
  Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Kabiri
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Hants
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Tom Raz
authors.initials: TR
authors.lastname: Yarkoni
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Esther
authors.initials: E
authors.lastname: Shaulof
authors.affiliation: Department of Neonatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Smadar Eventov
authors.initials: SE
authors.lastname: Friedman
authors.affiliation: Braun School of Public Health and Community Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Ora
authors.initials: O
authors.lastname: Paltiel
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Nir-Paz
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Wesam E
authors.initials: WE
authors.lastname: Aljamal
authors.affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Yossef
authors.initials: Y
authors.lastname: Ezra
mesh_terms: D000328:Adult; D002353:Carrier State / Q000382:microbiology*; D005321:Extraembryonic Membranes / Q000382:microbiology*; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000382:microbiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000635:transmission*; D013292:Streptococcus agalactiae