{"title":"预防新生儿早发 B 群链球菌疾病:主要指南的全面回顾。","authors":"Eirini Boureka, Dimitrios Krasias, Ioannis Tsakiridis, Anna-Maria Karathanasi, Apostolos Mamopoulos, Apostolos Athanasiadis, Themistoklis Dagklis","doi":"10.1097/OGX.0000000000001223","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Group B <i>Streptococcus</i> (GBS) colonization during pregnancy is associated with significant neonatal morbidity and mortality and represents a major public health concern, often associated with poor screening and management.</p><p><strong>Objective: </strong>The aim of this study was to review and compare the most recently published influential guidelines on the screening and management of this clinical entity during antenatal and intrapartum periods.</p><p><strong>Evidence acquisition: </strong>A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada on the prevention of early-onset neonatal group B streptococcal disease was carried out.</p><p><strong>Results: </strong>There is a consensus among the reviewed guidelines regarding the optimal screening specimen type, indications for intrapartum antibiotic administration such as bacteriuria during pregnancy, clinical signs of chorioamnionitis or maternal pyrexia, and history of GBS-related neonatal disease. There is also agreement on several conditions where no intervention is recommended, that is, antepartum treatment of GBS and GBS-positive women with planned cesarean delivery and intact membranes. Controversy exists regarding the optimal screening time, with the Royal College of Obstetricians and Gynecologists stating against routine screening and on management strategies related to preterm labor and preterm prelabor rupture of membranes.</p><p><strong>Conclusions: </strong>The development of consistent international practice protocols for the timely screening of GBS and effective management of this clinical entity both during pregnancy and the intrapartum period seems of paramount importance to safely guide clinical practice and subsequently improve neonatal outcomes.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"78 12","pages":"766-774"},"PeriodicalIF":4.3000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevention of Early-Onset Neonatal Group B Streptococcal Disease: A Comprehensive Review of Major Guidelines.\",\"authors\":\"Eirini Boureka, Dimitrios Krasias, Ioannis Tsakiridis, Anna-Maria Karathanasi, Apostolos Mamopoulos, Apostolos Athanasiadis, Themistoklis Dagklis\",\"doi\":\"10.1097/OGX.0000000000001223\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Group B <i>Streptococcus</i> (GBS) colonization during pregnancy is associated with significant neonatal morbidity and mortality and represents a major public health concern, often associated with poor screening and management.</p><p><strong>Objective: </strong>The aim of this study was to review and compare the most recently published influential guidelines on the screening and management of this clinical entity during antenatal and intrapartum periods.</p><p><strong>Evidence acquisition: </strong>A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada on the prevention of early-onset neonatal group B streptococcal disease was carried out.</p><p><strong>Results: </strong>There is a consensus among the reviewed guidelines regarding the optimal screening specimen type, indications for intrapartum antibiotic administration such as bacteriuria during pregnancy, clinical signs of chorioamnionitis or maternal pyrexia, and history of GBS-related neonatal disease. There is also agreement on several conditions where no intervention is recommended, that is, antepartum treatment of GBS and GBS-positive women with planned cesarean delivery and intact membranes. 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引用次数: 0
摘要
重要性:妊娠期 B 群链球菌(GBS)定植与新生儿的重大发病率和死亡率有关,是一个重大的公共卫生问题,通常与筛查和管理不善有关:本研究旨在回顾和比较最近出版的关于产前和产中这一临床实体的筛查和管理的有影响力的指南:对美国妇产科医师学会、英国皇家妇产科医师学会、澳大利亚和新西兰皇家妇产科医师学会以及加拿大妇产科医师学会关于预防早发新生儿 B 组链球菌病的指南进行了描述性回顾:结果:所审查的指南就最佳筛查标本类型、产前使用抗生素的指征(如孕期细菌尿、绒毛膜羊膜炎或产妇发热的临床表现以及与 GBS 相关的新生儿疾病史)达成了共识。对于不建议采取干预措施的几种情况也达成了一致,即 GBS 产前治疗和计划剖宫产且胎膜完整的 GBS 阳性产妇。关于最佳筛查时间还存在争议,英国皇家妇产科医师学会反对常规筛查,并反对与早产和早产前胎膜破裂相关的管理策略:为及时筛查 GBS 以及有效管理孕期和产期的这一临床实体,制定一致的国际实践协议似乎对安全指导临床实践和改善新生儿预后至关重要。
Prevention of Early-Onset Neonatal Group B Streptococcal Disease: A Comprehensive Review of Major Guidelines.
Importance: Group B Streptococcus (GBS) colonization during pregnancy is associated with significant neonatal morbidity and mortality and represents a major public health concern, often associated with poor screening and management.
Objective: The aim of this study was to review and compare the most recently published influential guidelines on the screening and management of this clinical entity during antenatal and intrapartum periods.
Evidence acquisition: A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada on the prevention of early-onset neonatal group B streptococcal disease was carried out.
Results: There is a consensus among the reviewed guidelines regarding the optimal screening specimen type, indications for intrapartum antibiotic administration such as bacteriuria during pregnancy, clinical signs of chorioamnionitis or maternal pyrexia, and history of GBS-related neonatal disease. There is also agreement on several conditions where no intervention is recommended, that is, antepartum treatment of GBS and GBS-positive women with planned cesarean delivery and intact membranes. Controversy exists regarding the optimal screening time, with the Royal College of Obstetricians and Gynecologists stating against routine screening and on management strategies related to preterm labor and preterm prelabor rupture of membranes.
Conclusions: The development of consistent international practice protocols for the timely screening of GBS and effective management of this clinical entity both during pregnancy and the intrapartum period seems of paramount importance to safely guide clinical practice and subsequently improve neonatal outcomes.
期刊介绍:
Each monthly issue of Obstetrical & Gynecological Survey presents summaries of the most timely and clinically relevant research being published worldwide. These concise, easy-to-read summaries provide expert insight into how to apply the latest research to patient care. The accompanying editorial commentary puts the studies into perspective and supplies authoritative guidance. The result is a valuable, time-saving resource for busy clinicians.