Written By Eeka King B.H.Sc (Acup)
A Case Study
A female patient, who I have been treating throughout her pregnancy, presents one week with a positive swab result for Group B streptococcal (GBS) Infection.
What is Group B Streptococcus?
Group B Streptococcus, commonly known as Strep B or GBS is a common bacterium that is found in the body. It is usually harmless in adults; however, can cause serious illness and sometimes death, especially in newborn infants, the elderly and patients with compromised immune systems. Up to 30% of women carry the bacterium in their vagina or rectum. Sometimes, a woman who has group B strep can infect her baby during delivery. This can sometimes cause serious illness in the newborn.
Group B strep is not the same as other types of streptococci bacteria, such as those that cause strep throat. Most often, group B strep causes no symptoms (asymptomatic) or problems in adults; however, it can still infect a newborn during birth. Pregnant women are routinely swabbed for strep B around the 36 week mark. This involves using cotton swabs to take samples from the vagina and anus. The samples are then sent to a laboratory. The results show whether you have group B strep (GBS) bacteria in your genital area. These test results cannot say whether or not your baby will become infected with group B strep.
Statistics show that about one of every 100-200 (0.5-1%) babies born to a GBS-colonized mother will develop GBS infection. If group B strep infects your baby, symptoms may take time to appear. Early-onset infection occurs within the first week of life, usually within a few hours of birth. Late-onset infections occur after the first week, usually within 90 days of birth. The baby may have infections in the blood, lungs, brain or spinal cord, or, more rarely, in a single, isolated spot such as a bone or joint. The infection will need prompt medical treatment. The mother may also become very ill from the infection after the delivery.
Treatment for group B strep
If a woman is at risk of group B strep infection, they will be given an antibiotic to help stop the infection. The antibiotic is given through an intravenous line during labour and delivery.
The availability of IV antibiotics has undoubtedly saved the lives of many babies. But, like many other obstetric life-savers, this intervention carries risks as well as potential benefits. The balance of risks and benefits will be different for each family, and as with any offer of medical treatment, it is up to the individual to decide whether to accept it.
In brief, the risks of antibiotics for GBS prophylaxis are:
- IV antibiotics medicalise labour – mother is almost always restricted to hospital.
- Mother may have an allergic reaction to antibiotics, up to and including anaphylactic shock, which can be fatal. 1 in 10,000 women receiving antibiotics for GBS can be expected to go into anaphylactic shock, and 1 in 10 so affected will die (ref: RCOG paper on GBS).
- Baby may become more at risk of infection from other, antibiotic-resistant organisms
A 28 year old pregnant patient presents with a positive swap result for GBS. She is very upset by this news and her previous positive outlook on her impending labour was greatly diminished. She wanted a ‘natural labour’ and felt that an antibiotic drip would be invasive to the labour and would not be impacting positively on her health and for a healthy start of her baby’s life. She also felt that it was a big consideration for such a small (0.5- 1%) chance that she may infect her baby.
Other than the positive swab for GBS she was in excellent health and had experienced no pregnancy complications.
Is there a natural alternative to antibiotics in GBS infected women?
As a traditional Chinese medical practitioner I wondered if I would be able to help eradicate the Strep B infection before the onset of labour. In TCM, infection is considered to be heat or toxic heat invasion in the body. There is a formula in Chinese medical pharmacopeia that is also known as the ‘natural antibiotic’ and has been known to treat some inflammatory heat conditions.
From a Chinese medical perspective the patient did not present with a great deal of heat signs, she had no symptoms of having been infected with strep B and her pulse and tongue analysis indicated healthy pregnancy signs. The body is also generally slightly hotter and damper in pregnancy than normal.
I decided to try one of the Chinese Antibiotic formulas – Huang Lian Jie Du Tang. There has been no precedent for its use in GBS and it is not a formula that you would often prescribe in pregnancy. So with caution I prescribed a very small dose to be taken every day for the duration of one week. I asked the patient to schedule another swab test for GBS in one week’s time.
A few days after taking the Chinese herbal medicine the patient reported that her vaginal discharge had completely cleared up. She said that she had experienced more discharge recently; however, she had read in all pregnancy literature that it was normal to have a greater amount in pregnancy, so she didn’t think it was a symptom of imbalance. Due to this she had a very good feeling that the herbal medicine was eradicating the infection.
One week later the patient had another swab test for GBS and the results came back negative. The patient was ecstatic.
Chinese Herbal medicine may be an alternative to antibiotics for woman in pregnancy to eradicate Group B Streptococcal infection and its potential risk of illness in a newborn baby.
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