Learn about Group B Streptococcus Infection (GBS)

Since i have nothing to post. All the happy pictures i want to share are still in my camera...


Just to share this info with all parents out there. Like Norashikin, most of us do not know what is GBS, including me. But everyday we learn new things, right?

The below case happenned in Singapore just recently.


Mum's infection kills baby

Not knowing about her condition, she passes it to newborn during childbirth
FIRST, his blood pressure went down. Then, his heartbeat started to slow yesterday.
By Shree Ann Mathavan


21 December 2008

FIRST, his blood pressure went down. Then, his heartbeat started to slow yesterday.
After 21 days at the Children's Intensive Care Unit (ICU) at KK Women's and Children's Hospital (KKH), baby Rizal Idris breathed his last.
He was barely a month old.

The baby, who weighed 2.93kg at birth on 27 Nov, had been fighting for his life because of a bacterial infection that his mother had caught while she was carrying him.
His mother did not know that she was suffering from a vaginal infection that affects about 14 per cent of pregnant women here. She gave birth to him at KKH.

Baby Rizal suffered from what is known as Group B Streptococcus Infection (GBS). It was passed on from his mother, Madam Norashikin Latiff, 31, during delivery.
He became unconscious and critically ill with brain injury, and his various dysfunctional organs were supported by machines.

It was a heartbreaking turn of events for bank officer Madam Norashikin and her husband, Mr Idris Makrob, 34, a civil servant, who had been looking forward to having their second child.
The couple have a 5-year-old son who was born without any difficulty, also at KKH.
Mr Idris, with his voice breaking, said after his son's death: 'Day in day out, we were always hoping that he would recover. But after all he has been through, we were prepared. '

Worried sick
The couple had been worried sick over their baby for weeks, and they want to know how such a thing could have happened in the first place.

While Madam Norashikin had been seeking treatment for a vaginal infection at KKH from May this year, she claimed that she was never informed by the hospital that she had GBS.
This is disputed by the hospital, who said Madam Norashikin was screened for GBS at 15 weeks during her pregnancy and then again at 35 weeks. She was found to have light colonisation of GBS the first time, but tested negatively the second time.

The test results would have been known to the patient, the spokesman said.
Besides this, the spokesman said that Madam Norashikin was informed by a staff nurse that she had GBS before mother and child were discharged, on 28 Nov.

The hospital also claimed that the nurse had told her of the symptoms to watch out for in Rizal.
But the mother of two insists: 'Nobody mentioned anything about GBS. All I was told was that I had a 'normal vaginal infection'.

'We were kept in the dark, I had no clue what GBS was and what its effect would be on my baby.'
GBS can be prevented from being passed on to the baby by administering antibiotics through an intravenous drip during labour.

Day of delivery
The first time the couple claimed they heard anything about GBS was on the day of Rizal's delivery.
Even then, it was not from a doctor but from a representative of the cord blood donor programme, Mr Idris claimed.
He was told by this representative that his wife's cord blood might not be suitable for donation as she could have GBS.

Mr Idris said: 'I was shocked. My first reaction was, what is GBS? I'm a layman. I don't understand what it meant.'

In addition to not being informed, MrIdris also claimed his wife was administered the GBS antibiotics late, when her contractions had already begun and her cervix had dilated to 8cm.
However, the hospital spokesman noted that while the drugs were given during birth, the baby was delivered very shortly after admission - within 21/2 hours.

After the baby exhibited symptoms such as poor feeding and vomiting in hospital - symptoms of GBS - Mr Idris said he had informed two different nurses three times, but claimed his concerns were repeatedly brushed off.

The hospital said that during Rizal's stay at the hospital, he was tolerating feeds of 25 to 30ml by the nurses.
It was only on Saturday, the third day after Rizal's birth, that the couple realised all was not well with their baby.
Madam Norashikin recalled that her baby turned pale and his breathing was shallow at around 11.30pm that night.
He had been sleeping for the whole afternoon and the parents were worried.
They immediately rushed the baby to KKH's accident & emergency department the same night, whereupon his condition was pronounced critical.
Rizal was later transferred to the ICU.
Both parents were at the hospital last night going through the paperwork to take their baby's body home.
He will be buried today.

Mr Idris, who lost about 2kg since his daily hospital vigils from the time Rizal was admitted, had told The New Paper before his son died: 'I've not gone home for more than two weeks... I hardly slept. How to?'

He, his wife and their older son live in a five-room Housing Board flat in Punggol, but they had been spending time at a parents' room at KKH.
Rizal's illness had taken a toll on his mother, who looked fatigued when speaking to us before he died.

Brave front
She said she had tried to put a brave front whenever she stood in front of her baby.
She said: 'I didn't want Rizal to be sad, we wanted him to be strong and fight on.'
The parents had constantly tried to seek some form of physical response from the baby, by either talking to him or even playing to him a song his older brother sang and recorded on a handphone.
But heartbreakingly, there was no response from the infant.

The couple, who have a total monthly household income of $4,500, are not sure how much their medical bills will amount to.

Mr Idris said: 'All I wanted was for my son to recover, to survive.'



Hospital: Baby didn't show GBS symptoms during his stay
GBS infection in babies is rare in Singapore - 0.3 to 0.4 per 1000 births, compared to 2 per 1,000 births in the US.
Despite this, to minimise the risk of transmission to the baby, antibiotics was given to Madam Norashikin during labour, KKH said.
The hospital said that baby Rizal did not exhibit any symptoms of GBS infection, pneumonia or meningitis during his hospital stay.
Hence, he was discharged after 24 hours of observation with the advice to be followed up at the polyclinic the next day.
The baby was also referred to the neonatal team for assessment and follow-up.
KKH said that almost all cases of severe GBS infection would manifest within the first six hours of life. Unfortunately, Rizal's condition subsequently deteriorated, leading to his readmission.
It said that most cases of GBS infections could be treated with antibiotics, but in severe cases such as Rizal's, it could be life-threatening.


5 THINGS ABOUT GBS
(From Dr Tan Eng Kien, associate consultant of obstetrics and gynaecology at NUH)
1 WHAT is Group B Streptococcus (GBS)?
It is a bacteria commonly found in a proportion of women (about 14 per cent of pregnant women in Singapore) and does not normally cause any harm.
2 How can it be detected?
GBS carriage can be detected incidentally when swabs are taken in the course of tests to rule out other infections.
Routine testing for GBS during pregnancy is recommended in the US, Canada and Australia. There is no recommendation for routine screening of GBS here.
3 What are the risks of GBS to the mother and baby?
There is no harm of GBS carriage to the mother. However, if the mother is a GBS carrier, GBS can be passed from her to the baby during vaginal delivery.
4 How dangerous is GBS for the baby?
Most babies who come into contact with GBS during birth are not harmed.
Only a very small number (0.265 per 1,000 live births, Singapore figures) are diagnosed with GBS infection after birth, and become seriously ill.
5 What are the signs?
Babies with severe GBS infections show signs of infection within 12 hours.
They could be floppy, unresponsive and feed poorly.
Other symptoms include fast or slow heart rate, high or low temperatures, difficulty in breathing, low blood sugar levels, and low blood pressure.

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You can read more about GBS in babycentre.com