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GROUP B STREPTOCOCCAL (GBS) DISEASE SCREENING AND TREATMENT DURING PREGNANCY: NURSE-MIDWIVES‘ CONSISTENCY WITH 1996 CDC RECOMMENDATIONS

Authors

  • Kathaleen C. Bloom CNM, PhD,

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      UNF Department of Nursing, 4567 St. Johns Bluff Road South, Jacksonville, FL 32224.
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    • Kathaleen C. Bloom is an associate professor in the College of Health, Department of Nursing at the University of North Florida in Jacksonville, Florida. She is in clinical nurse-midwifery practice at the West Jacksonville Family Health Center, Jacksonville, Florida.

  • C. Ann Ewing CNM, MSN

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    • C. Ann Ewing received her nurse-midwifery education from the University of Florida Nurse-Midwifery Program in 1993. She is currently working in full-scope nurse-midwifery practice in Orange Park, Florida.


UNF Department of Nursing, 4567 St. Johns Bluff Road South, Jacksonville, FL 32224.

ABSTRACT

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).

Methodology: 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.

Conclusion: 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.

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