Group B streptococcal disease guideline

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36) | The Royal College of Obstetricians and Gynaecologists. 

Group B Streptococcal Disease (GBS) is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.

In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.

The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families.

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36)

Advertisements

‘Eating for two’ pregnancy myth

restaurant-691377_1920.jpg

The Royal College of Obstetricians and Gynaecologists (RCOG) has highlighted the publication of a survey, to understand women’s perceptions of how much they should eat during pregnancy.

The survey, commissioned by the National Charity Partnership, a partnership between Diabetes UK, the British Heart Foundation (BHF) and Tesco, found 69 per cent of women are unaware of how many extra calories they need to consume during pregnancy. 63 per cent report feeling under pressure from others to eat larger meals than normal with 14 per cent of pregnant respondents saying that this pressure is constant.

The RCOG is working with the National Charity Partnership to bust the ’eating for two’ myth and make it easier for people to understand how to make healthy choices during pregnancy to avoid unhealthy weight gain.

Read more via RCOG

 

 

Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia

Daniel L. Rolnik et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia  New England Journal of Medicne 28th June 2017 

24117471833_78847b3470_z

Image source: Mike Steele – Flickr // CC BY 2.0

Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia.

This multicenter, double-blind, placebo-controlled trial, randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation.

Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a significantly lower incidence of preterm preeclampsia than that with placebo.

Full article available via the New England Journal of Medicine

Physical activity in pregnancy

This infographic is the latest addition to a series commissioned by the UK Chief Medical Officers. It aims to provide clarity and consistency, and to equip health professionals to deliver evidence based recommendations on physical activity in pregnancy.

The aim is to ensure pregnant women are aware of the benefits of being active throughout their pregnancy and are clear about the physical activity recommendations. The infographic provides details regarding frequency, intensity and time, together with specific examples of suitable activities and key safety messages.

 

active pregnancy

Image source: http://www.gov.uk

Postnatal mental illness

The National Childbirth Trust (NCT) has published The hidden half: bringing postnatal mental illness out of hiding.

pnd

Image source: http://www.nct.org.uk

The Hidden Half campaign surveyed 1,000 women who had recently had a baby and found that half had a mental health or emotional problem postnatally or during pregnancy. Of these, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment. Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.

The document can be downloaded here

Additional link: RCGP press release

Women’s Smoking Status at Time of Delivery

This report presents the latest results and trends from the women’s smoking status at time of delivery (SATOD) data collection in England. 

The results provide a measure of the prevalence of smoking among pregnant women at Commissioning Region, Region and Clinical Commissioning Group level.

Key facts

In 2016/17:

  • 10.5 per cent of pregnant women were known to be smokers at the time of delivery. This compares to 10.6 per cent for the previous year (2015/16), and is down from 15.1 per cent in 2006/07.
  • This is the second consecutive year that the proportion has been below the national ambition of 11 per cent.
  • The CCGs with the lowest proportion of women known to be smokers at the time of delivery were NHS West London (2.3 per cent), NHS Richmond (2.5) and NHS Hammersmith and Fulham (2.7).
  • The CCGs with the highest proportion were NHS Blackpool (28.1 per cent), NHS Hull (22.9) and NHS North East Lincolnshire (22.3).
  • 104 out of 209 CCGs met the national ambition of 11 per cent or less.

The report can be viewed here

Lithium Use in Pregnancy and the Risk of Cardiac Malformations

There has been concern that exposure to lithium early in pregnancy may be associated with a marked increase in the risk of Ebstein’s anomaly (a right ventricular outflow tract obstruction defect) in infants and overall congenital cardiac defects, but data are conflicting and limited | NEJM

https://www.flickr.com/photos/ephotography29/3093917122/

Image source: Erin – Flickr // CC BY-NC-ND 2.0

Methods: We conducted a cohort study involving 1,325,563 pregnancies in women who were enrolled in Medicaid and who delivered a live-born infant between 2000 and 2010. We examined the risk of cardiac malformations among infants exposed to lithium during the first trimester as compared with unexposed infants and, in secondary analyses, with infants exposed to another commonly used mood stabilizer, lamotrigine. Risk ratios and 95% confidence intervals were estimated with control for psychiatric and medical conditions, medications, and other potential confounders.

Conclusions: Maternal use of lithium during the first trimester was associated with an increased risk of cardiac malformations, including Ebstein’s anomaly; the magnitude of this effect was smaller than had been previously postulated

Full reference: Patorno, E. et al. (2017) Lithium Use in Pregnancy and the Risk of Cardiac Malformations. New England Journal of Medicine. 376 pp. 2245-2254