A healthy 29-year-old gravida 2 woman at 39 weeks has been in labor for 3 hours. She had a positive vaginal-anal culture for GBS at 37 weeks' gestation. Which one of the following statements is correct?
- Asymptomatic rectovaginal colonization is present in 60% of pregnant women.
- The transmission rate from mother to baby is approximately 25%.
- A rectovaginal culture should have been obtained at the first prenatal visit.
- Neonatal sepsis occurs in 1% of colonized mothers.
- Treatment with penicillin in labor is necessary only for heavy colonized mothers.
Answer(s): D
Explanation:
Approximately 20% of pregnant women have positive rectovaginal cultures. Vertical transmission rate from mother to baby is approximately 75%. A rectovaginal culture is not indicated at the first prenatal visit because the pregnant woman may subsequently convert from a negative to a positive culture. For this reason, all pregnant women should have a rectovaginal culture at 3637 gestational weeks. If the woman goes into preterm labor before a culture is obtained, she should be treated with penicillin (gentamicin if she is penicillin allergic). The rate of neonatal sepsis is 1% of colonized mothers, a serious infection that may cause pneumonia, meningitis, and death.
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