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A Crucial Prenatal Test

A test that screens pregnant women for group B streptococcal (GBS) disease -- which poses more of a health risk for newborns than rubella or spina bifida -- is easy, inexpensive, and widely available. So why aren't all doctors offering this as part of routine prenatal care?

Caused by a bacteria found in the digestive and reproductive tracts in 30 percent of adults, GBS rarely causes symptoms. In fact, most people are unaware they carry it. That's the problem for pregnant women: Their babies can pick up GBS by breathing in bacteria from the amniotic fluid after the water breaks, or while passing through the birth canal. Although only 1 to 2 percent of newborns who have the bacteria actually get the disease, the complications include blood infections, meningitis, and, though rare, death.

There are two recommended approaches to prevent a newborn from contracting the disease; the first is to test women during their 35th to 37th weeks. Less invasive than a routine Pap smear, the test involves taking swabs of cells from the vagina and rectum. Often covered by health insurance, it costs about $20 and takes about two days for results.

If you test positive, your doctor will treat you with intravenous antibiotics during labor. But since there's a small chance that swab tests can give a false result, the second approach is to look for red flags -- such as early labor, a fever during childbirth, or a 12- to 18-hour span between the time your water breaks and labor actually starts. The treatment for any of these red flags is the same: IV antibiotics during labor. So if you're not sure whether your doctor is planning to give you the swab test, make sure to request it.

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