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Antepartum Membrane Stripping in GBS Carriers, Is It Safe? (The STRIP-G Study).

Kabiri D, Hants Y, Yarkoni TR, Shaulof E, Friedman SE, Paltiel O, Nir-Paz R, Aljamal WE, Ezra Y - PLoS ONE (2015)

Bottom Line: We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

ABSTRACT

Objective: Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. We conducted 'the STRIP-G study' in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping.

Study design: We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.

Results: A total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).

Conclusions: Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.

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Related in: MedlinePlus

‘Compromised Neonate’ Rate and Composite Adverse Maternal Outcomes Rate.
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pone.0145905.g003: ‘Compromised Neonate’ Rate and Composite Adverse Maternal Outcomes Rate.

Mentions: We observed no cases of neonatal sepsis, death or serious neonatal morbidity in the study. The ‘compromised neonate’ rate was 5.9% (8/135), 8.6% (31/361), and 4.3% (2/46) in the GBS-positive, GBS-negative, and GBS-unknown group, respectively (P = 0.530) (Fig 3). The Odds Ratio between GBS-Positive and GBS-Negative groups was 0.67 [P = 0.33 (95%, CI = 0.30–1.50)]. Neonatal outcomes and the incidence of clinical indicators for possible-early-onset of neonatal infection are summarized in Table 3. The significant difference of hospital stay and NICU admission are due to the GBS-Unknown group.


Antepartum Membrane Stripping in GBS Carriers, Is It Safe? (The STRIP-G Study).

Kabiri D, Hants Y, Yarkoni TR, Shaulof E, Friedman SE, Paltiel O, Nir-Paz R, Aljamal WE, Ezra Y - PLoS ONE (2015)

‘Compromised Neonate’ Rate and Composite Adverse Maternal Outcomes Rate.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697801&req=5

pone.0145905.g003: ‘Compromised Neonate’ Rate and Composite Adverse Maternal Outcomes Rate.
Mentions: We observed no cases of neonatal sepsis, death or serious neonatal morbidity in the study. The ‘compromised neonate’ rate was 5.9% (8/135), 8.6% (31/361), and 4.3% (2/46) in the GBS-positive, GBS-negative, and GBS-unknown group, respectively (P = 0.530) (Fig 3). The Odds Ratio between GBS-Positive and GBS-Negative groups was 0.67 [P = 0.33 (95%, CI = 0.30–1.50)]. Neonatal outcomes and the incidence of clinical indicators for possible-early-onset of neonatal infection are summarized in Table 3. The significant difference of hospital stay and NICU admission are due to the GBS-Unknown group.

Bottom Line: We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

ABSTRACT

Objective: Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. We conducted 'the STRIP-G study' in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping.

Study design: We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.

Results: A total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)); while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).

Conclusions: Antepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes.

Show MeSH
Related in: MedlinePlus