Paeds Cases · fetal-neonatal-and-perinatal
Perinatal infection screening and prevention — case
Long case and communication station.
On this page
Study tools
Target exams
RACP DCEMRCPCH Clinical
Prompt
A GBS-colonised term infant with inadequate intrapartum prophylaxis and early respiratory distress, plus a hepatitis B risk to address.
Case summary
A term male is born at 39 weeks by spontaneous vaginal delivery after 18 hours of ruptured membranes. The mother is known to be Group B Streptococcus positive on a 36-week swab, but she received only one dose of intravenous benzylpenicillin two hours before delivery. Her booking antenatal screens were normal except that she is hepatitis B surface antigen positive. At four hours of age the infant is grunting, tachypnoeic (respiratory rate 72) and has cool peripheries and poor feeding. [1] [3]
References4ShowHide
- [1]Schrag SJ Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. New England Journal of Medicine, 2000.PMID 10620644
- [3]Verani JR Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recommendations and Reports, 2010.PMID 21088663
- [5]Stoll BJ Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies. JAMA Pediatrics, 2020.PMID 32364598
- [9]Schillie S Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recommendations and Reports, 2018.PMID 29939980