UC, Pregnancy and Group B Strep

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31fan
Regular Member


Date Joined Feb 2007
Total Posts : 34
   Posted 6/16/2008 11:16 AM (GMT -6)   
I'm 36 weeks pregnant, and a urine test in early pregnancy showed that I was colonized with Group B Strep.  The normal protocol is for me to receive Ampicillin via IV during labor.  I'm hesitant about receiving antibiotics because they cause me GI issues, and I'm worried that the combo of that and the hormonal changes post-partum will send me into a flare.  On the other hand, I obviously don't want to risk my newborn suffering a very dangerous strep infection, though the risk is small (I think 1 in 3000).
 
Anyone been in a similar situation?  Any advice?
Diagnosed with UC in transverse and descending colon in Feb. 2007
Doing well so far on Asacol 800 mg. 2x a day
Also take 25 mg. Paxil, 100 mg. Wellbutrin, 1 probiotic pearl per day
Currently off other meds because I'm newly PG, due next July


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 6/16/2008 11:26 AM (GMT -6)   
Hey 31- while i have no experience with your issue (or pregnancy) I have heard on the crohns forum that some drugs that cause problems for us orally are less harmful when given IV.

kb5
Veteran Member


Date Joined Jan 2007
Total Posts : 1015
   Posted 6/16/2008 11:39 AM (GMT -6)   
Have you called your GI?

Is your OB a high risk ob? it may be worth a second opinion if there is time.

good luck and congrats!
Kelly, 30

Left sided UC diagnosed 1/98 age 19, Pan colitis diagnosed 1/07
Currently on 4x3 Asacol, no more pred after two years!!!! Off imuran as remicade is working!
Prontonix once daily for acid reflux, zofran 8mg every six hours for nausea
Remicade started 3/1/08...just had 4th infusion


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 6/16/2008 11:49 AM (GMT -6)   
i develped something sort of like that at about 35 weeks, and i was given flagyl, which isn't exaclty for that, but it is the only antibiotic i can take safely. It cleared it up, but and i am not sure if this was because of the infection, or because of the fact that our AC went out and it was 100 degrees in my house, I went to the dr for this on Wed, and then on Thurs our air went out, and on Friday i went into early labor. But it was stopped and all was well, but you might want to check into that.
Hope all goes well

hekela
Veteran Member


Date Joined Nov 2006
Total Posts : 731
   Posted 6/16/2008 12:45 PM (GMT -6)   
hi 31fan,
i encourage you to read this brief article.

http://www.mothering.com/sections/experts/odent-archive1.html#strep

as you look at the top of the page, there are several clickable links that will take you to the right spot on the long page. near the bottom of the list is group b strep.

if you are into trying natural things at all, there is something you could try. the main thing i noticed is that the bacteria can come and go and that you should be retested as close to your delivery as possible.

if you are able to contact a midwife in your area, you may be able to ask about this. i have a friend who also tested positive with both pregnancies and didn't do antibiotics. the midwife assured her that if there was anything passed onto baby then they would treat the baby at that time. both babies were fine in her case.

avoid the antibiotics if you can but obviously don't take unnecessary risks. just make an informed decision and make sure you're not still worrying about it during labor.

hope your birth goes well! :)
29, happily married, stay at home mom to 2.5 year old son. due to have another boy 9/17/08
UC (probably pancolitis, but no c-scope yet), diagnosed June 2006, started having major symptoms sometime in January 2006, about 3 months after childbirth. 2nd flare (minor) may 2007 after taking caprylic acid for 2 weeks.

-Prednisone 8/28/06-2/28/07. and again may '07, 8 week course.
-Prayer! asacol, probio, ground psyllium husk, prenatal, folic acid, cal-mag

may you live all the days of your life.


quincy
Elite Member


Date Joined May 2003
Total Posts : 30708
   Posted 6/16/2008 1:43 PM (GMT -6)   
I don't think you have any choice but to take the appropriate meds before the birth of your baby.

There is NO guarantee you won't be in a flare regardless.

I would never risk the possible outcome of not taking the antibiotics no matter what anyone says. At least women today are tested before rather than after the death of their babies. You'll be taking them IV...not orally for one...I think that in itself will be better.

Do make sure you're taking your UC meds .... both oral AND rectal.
As well...probiotics.

No, I've never been pregnant.....so my posting is based purely on if I were and my UC experience with surgeries, infections and taking antibiotics as well as UC meds.

A flare is a small price to pay from my perspective. You were willing to become pregnant knowing the risk of that possibility....you also know that taking your meds will help lower the likelihood of worse symptoms.

I hope all goes well for you,
quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 6/16/2008 4:51 PM (GMT -6)   
Group B strep, if the baby becomes infected, can cause anything from a mild skin rash to severe brain damage to death. The chances are small, but the stakes are very high. I've worked with babies who were very severely damaged by neonatal strep. Yes, it can be treated, but considering that baby's immune system isn't yet developed to help fight it off, success is not always assured.

Asking for a re-test during your third trimester is a good idea. Then talk to your OB to see if there are any alternative antibiotics, as Amoxicillin tends to be one of the more difficult ones for us. Also advise your doctor that you will need to be on high doses of probiotics to combat the potential for C. diff overgrowth in your colon from the antibiotics, and he will need to arrange for you to be able to bring this medication from home, keep it in the refrigerator at the hospital and take it. (Or it may just be more simple to have a visitor bring it in to you each day.)

I agree that a flare is annoying and painful, but it does end. Having a baby with problems is forever.

Either way, it's your decision to make and I wish you and your baby only the best.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


bap06
Regular Member


Date Joined Jun 2008
Total Posts : 57
   Posted 6/16/2008 6:16 PM (GMT -6)   
On a side note, if you do decide on the antibiotics, you may want to arrange to be induced. They didn't get my friend the antibiotics in time, because she delivered pretty much right when she got to the hospital (the baby was fine, though!). Love the tip about getting retested closer to delivery. And as for a flare, I had a pretty quick, fairly easy delivery with no antibiotics, and still flared postpartum. I'm quickly learning that often colitis does what colitis wants to do, regardless of our best efforts to keep the flares away! Good luck with your decision, and with the rest of your pregnancy.
*Diagnosed 10/07 (6 months pregnant w/ 2nd baby)
*Asacol (4 pills 3x a day)
Canasa
Prilosec
Calcium, multivitamin, Metamucil


sore_guts
Regular Member


Date Joined Jun 2007
Total Posts : 186
   Posted 6/17/2008 8:07 AM (GMT -6)   
I also tested positive for this during my second pregnancy and had the IV antibiotics during labor.  I didnt flare right away, but about 8 weeks postpardum went into a terrible flare.  It probably wasnt from the antibiotics though since it was so much later.
I also had antibiotics during my first labor for another reason (Dr thought my water had broken days earlier) and never had a flare after that labor and it was long so I was exposed to antibiotics for a long time that first time around.
So I think its best to go with what your Ob reccommends, but I would defintely discuss your concerns with him/her and find out if there are choices are far as which antibiotics can be used and discuss with your GI was well.  And ask to have your probiotics cleared ahead of time as allowable meds in the hospital (if you sneak them in they are supposed to confiscate them).
Good luck, I wish you a speedy and healthy labor and delivery.
 
sore_guts
 
36 year old female with left-sided UC
lialda 1 pill  3 times/day
Rowasa enemas every other night
iron supplements 1/day
multi-vitamin 1/day
Digestive Advantage Colitis formula 2/day
 
 


shannon1
Regular Member


Date Joined Feb 2005
Total Posts : 369
   Posted 6/17/2008 9:05 AM (GMT -6)   
I had group B during my second pg. It was diagnosed early and i was retested two more times (once close to birth). I had IV antibiotics. I was already flaring, so i don't know about that.

I can tell you that i would have risked anything to get my baby here safe/healthy. I delivered two preemies and took TONS of meds to stop contractions, labor, flares, ect, and i would never have thought twice about it. Both babies are happy healthy children now.

Obviously, this has to be a personal decision, but talk to your OB and your GI and see what they say also. Good luck, shannon
2003, dx moderate UC
2000, dx selective IGA deficiency w/ anti IGA antibodies
2000, dx Antipholipid Antibody Syndrome
1999-current, chronic hemmoragic ovarian cysts, w/ partial ovary removal
1977, complete reconstruction of foot after lawnmower accident (chronic pain)
 
Meds
6mp 75mg, prednisone 40mg (just starting meds again)
percocet 5mg 3x day
potassium 3x day
 


PeanutMom
Regular Member


Date Joined Jun 2008
Total Posts : 197
   Posted 6/17/2008 11:03 AM (GMT -6)   
one PP noted check for alternative antibiotics. Talk with your GI and OB, there's some that don't seem to cause flares as much as others. I know I refuse amoxicillin (not sure if it's in the same family with ampicillin)because of flare and yeast infections (together it feels deadly LOL) but I can safely take xithromax.

That's just me.

I didn't flare at all after giving birth either (no antibiotics). . . in fact I ended up constipated unless I drank almost 1/2 a gallon of apple juice a day. That was a dilemma I'd never experienced. . .I'm not sure which was worse LOL
Kim ~ Mom of Nathaniel aka "Peanut" 18months old
========================
I'm a married 36 yr old mom and here's "The list "
- UC 1997 currently unmedicated was on Colozal from 2001-2007
- Stage 3 CKD (Chronic Kidney Disease) 2007 taking 7.5mg lisinopril
- Anemic - Ferolicit IV bi-weekly
- Ashermans Syndrome - no treatment
- Allergies - water - haven't been tested officially but pine suspected


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 6/17/2008 3:43 PM (GMT -6)   
Amoxicillin and ampicillin are the same drug, and it's one of the worst offenders for causeing severe diarrhea.

Since Vancomycin is the IV drug of choice for babies with GBS, I wonder if they could give you that instead. I've had it prophylactically with surgery before with no problem. Ampicillin isn't the only drug that will treat it, they usually use it because it's effective and less expensive. Talk to your OB about this.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


31fan
Regular Member


Date Joined Feb 2007
Total Posts : 34
   Posted 6/18/2008 10:03 AM (GMT -6)   
Thanks, everyone.  I will see about a retest this week and ask about alternative antibiotics, as well as about bringing probiotics.  It is interesting to know about Amox being one of the worst offenders.  I've had problems so far with Omnicef and Augmentin (which I know has Amox in it).  I'll ask about the Vancomycin as well as Azithromycin et al.
Diagnosed with UC in transverse and descending colon in Feb. 2007
Doing well so far on Asacol 800 mg. 2x a day
Also take 25 mg. Paxil, 100 mg. Wellbutrin, 1 probiotic pearl per day
Currently off other meds because I'm newly PG, due next July

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