Atualização na assistência pré-natal

Melo, Victor Hugo; Rio, Suzana Maria Pires do; Bernardo, Wanderley Marques

doi:10.1590/s0104-42302008000100012

Cited by 2 publications

(4 citation statements)

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“…While the Brazilian Medical Guidelines recommend GBS screening during prenatal care 22 IUGR: intra-uterine growth restriction; HIV: human immunodeficiency virus. *Variable with incomplete data.…”

Section: Discussionmentioning

confidence: 99%

Group B Streptococcus detection in pregnant women via culture and PCR methods

Wollheim

Sperhacke

Fontana

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population. Methods: Vaginal introitus and perianal samples were collected from 204 pregnant women, between the 35 th and 37 th weeks of pregnancy, at the Obstetrics and Gynecology Unit of the University of Caxias do Sul General Hospital between June 2008 and September 2009. All samples were cultured after enrichment in a selective medium and then assayed by culture and PCR methods. Results: The culture and PCR methods yielded detection rates of vaginal/perianal GBS colonization of 22.5% and 26%, respectively (sensitivity 100%; specificity 95.6%; positive and negative predictive values 86.8% and 100%, respectively). A higher prevalence of GBS colonization was detected in the combined vaginal and perianal samples by both culture and PCR assay analyses. Conclusions: PCR is a faster and more efficient method for GBS screening, allowing for optimal identification of women who should receive intrapartum antibiotic prophylaxis to prevent newborn infection.

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Section: Discussionmentioning

confidence: 99%

Group B Streptococcus detection in pregnant women via culture and PCR methods

Wollheim

Sperhacke

Fontana

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…The AD intervention included these guidelines and a 30-minute face-to-face education-oriented interview on antenatal GBS screening based on the national guidelines for antenatal care [2]. This was conducted by a trained physician and took place in the private offices of the participating obstetricians, in July and August, 2008.…”

Section: Methodsmentioning

confidence: 99%

“…Medical guidelines on prenatal care strongly recommend GBS screening of the vagina and anus between 35 and 37 weeks of gestation and intrapartum antibiotic prophylaxis of colonized women to prevent neonatal infection [1,2]. Despite their success as a strategy to prevent perinatal GBS disease, these recommendations have mostly been applied in developed countries only [3].…”

Section: Introductionmentioning

confidence: 99%

“…Despite their success as a strategy to prevent perinatal GBS disease, these recommendations have mostly been applied in developed countries only [3]. In Brazil, a prevalence of maternal colonization by GBS of between 15 and 25% suggests that universal screening is likely to be cost-effective in this country [4,5], and GBS screening is recommended by the Brazilian Medical Guidelines on prenatal care [2]. Interventions potentially effective in promoting the adherence of obstetricians to these guidelines are lacking in this country.…”

Section: Introductionmentioning

confidence: 99%

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Academic detailing and adherence to guidelines for Group B streptococci prenatal screening: a randomized controlled trial

Silva

Stein

Bordin

et al. 2013

BMC Pregnancy Childbirth

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BackgroundClinical practice guidelines (CPGs) recommend universal prenatal screening for Group B Streptococcus (GBS) to identify candidates for intrapartum antibiotic prophylaxis to prevent early onset neonatal GBS infection. Interventions to promote physician adherence to these guidelines are imperative. This study examined the effectiveness of academic detailing (AD) of obstetricians, compared with CPG mailshot and no intervention, on the screening of pregnant women for GBS.MethodsA randomized controlled clinical trial was conducted in the medical cooperative of Porto Alegre, Brazil. All obstetricians who assisted in a delivery covered by private health insurance managed by the cooperative in the 3 months preceding the study (n = 241) were invited to participate. The obstetricians were randomized to three groups: direct mail (DM, n = 76), AD (n = 76) and control (C, n = 89, no intervention). Those in the DM group were sent guidelines on GBS. The AD group received the guidelines and an educational visit detailing the guidelines, which was conducted by a trained physician. Data on obstetrician age, gender, time since graduation, whether patients received GBS screening during pregnancy, and obstetricians who requested screening were collected for all participant obstetricians for 3 months before and after the intervention, using database from the private health insurance information system.ResultsThree months post-intervention, the data showed that the proportion of pregnant women screened for GBS was higher in the AD group (25.4%) than in the DM (15.9%) and C (17.7%) groups (P = 0.023). Similar results emerged when the three groups were taken as a cluster (pregnant women and their obstetricians), but the difference was not statistically significant (Poisson regression, P = 0.108). Additionally, when vaginal deliveries were analyzed separately, the proportion screened was higher in the AD group (75%) than in the DM group (41.9%) and the C group (30.4%) (chi-square, P < 0.001).ConclusionsThe results suggest that AD increased the prevalence of GBS screening in pregnant women in this population.

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Atualização na assistência pré-natal

Cited by 2 publications

References 0 publications

Group B Streptococcus detection in pregnant women via culture and PCR methods

Group B Streptococcus detection in pregnant women via culture and PCR methods

Academic detailing and adherence to guidelines for Group B streptococci prenatal screening: a randomized controlled trial

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