6. VIDEO: What is the ‘Risk-based’ approach for GBS during pregnancy?

Group B Strep (GBS) Online Course

START HERE: GROUP B STREP (GBS) ONLINE COURSE

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Course Instructions
How does the course work?
Note on copyright
Notes on gender and spelling
Legal Disclaimer 1
Legal Disclaimer 2
Featured Speakers
Declarations of Interest

Session 1: Introduction to Group B Strep (GBS)

1. Session One: Learning Objectives
2. VIDEO: Why do you care about GBS? (2:56)
3. What is group B Strep?
4. VIDEO: What is group B Strep? (1:06)
5. Microbial properties of group B Strep
6. VIDEO: Microbial properties of group B Strep (5:22)
7. GBS and the human microbiome
8. VIDEO: Group B Strep and the human microbiome (2:19)
9. Carrying GBS in the human microbiome
10. VIDEO: Difference between carrying group B Strep and having a group B Strep infection? (1:24)
11. How is GBS carriage detected?
12. VIDEO: Who is most vulnerable to GBS infections? (1:46)
13. GBS infection in adults
14. Session One: Science References
15. Session One: Graded Test
16. Session One: Downloadable Handouts
17. Session One: Discussion Forum

Session 2: Group B Strep and Newborns

1. Session Two: Learning Objectives
2. VIDEO: GBS infection in newborns: A serious global problem (1:03)
3. Global statistics for carrying GBS in pregnancy
4. VIDEO: How can infants acquire group B Strep during labour and vaginal childbirth? (2:40)
5. How can infants acquire GBS during labour and vaginal birth?
6. VIDEO: How can infants acquire group B Strep after birth? (1:43)
7. How can infants acquire GBS after birth?
8. VIDEO: Risk of a newborn developing a GBS infection (3:22)
9. Risk of a newborn developing GBS infection
10. VIDEO: GBS infection and preterm birth (1:37)
11. GBS infection and preterm birth
12. VIDEO: GBS infection with C-section (0:49)
13. GBS and C-section
14. Session Two: Science References
15. Session Two: Graded Test
16. Session Two: Downloadable handouts
17. Session Two: Discussion Forum

Session 3: Signs Of Early And Late Onset GBS infection

1. Session Three: Learning Objectives
2. VIDEO: Difference between early-onset and late-onset GBS infections (1:47)
3. GBS is a serious risk to infant health
4. VIDEO: GBS is a cause of stillbirth (2:19)
5. GBS is a cause of stillbirth
6. VIDEO: Signs of early-onset GBS infection (1:49)
7. Signs of early-onset GBS infection
8. VIDEO: Signs of late-onset group B Strep infection (1:28)
9. Signs of late-onset GBS infection
10. VIDEO: Diagnosing group B Strep infection (1:06)
11. Rate of GBS infections across the world
12. VIDEO Treating group B Strep infection with antibiotics (1:45)
13. Treating GBS infections with antibiotics
14. VIDEO: Morbidity and mortality rates for GBS infection (2:27)
15. Key morbidity and mortality statistics from around the world
16. Session Three: Science references
17. Session Three: Graded Test
18. Session Three: Downloadable Handouts
19. Session Three: Discussion Forum

Session 4: Strategies For Preventing Early-Onset GBS Infection

1. Session Four: Learning Objectives
2. VIDEO: With no symptoms, how can you tell if you are a carrier for GBS? (1:38)
3. Types of test for GBS during pregnancy
4. VIDEO: Types of test for GBS carriage (2:14)
5. 'Risk-based' and 'Universal testing' strategies for GBS
6. VIDEO: What is the ‘Risk-based’ approach for GBS during pregnancy? (2:43)
7. What is a 'Risk-based’ approach to GBS during pregnancy?
8. VIDEO: What is ‘Universal screening’ for GBS during pregnancy? (2:14)
9. What is ‘Universal screening’?
10. VIDEO: Procedure for testing mother for GBS at 35-37 weeks’ gestation (1:54)
11. If a woman tests positive for carrying GBS
12. VIDEO: Effectiveness of ‘Universal Screening’ compared to the ‘Risk-based approach’ for GBS (1:19)
13. Which approach is more effective?
14. Session Four: Science References
15. Session Four: Graded Test
16. Session Four: Downloadable Handouts
17. Session Four: Discussion Forum

Session 5: Preventing GBS Infections With IV Antibiotics

1. Session Five: Learning Objectives
2. VIDEO: Preventing GBS infections with antibiotics (1:29)
3. How effective are Intrapartum Antimicrobial Prophylaxis (IAP) at preventing early-onset GBS infections
4. VIDEO: When are Intrapartum Antimicrobial Prophylaxis (IAP) administered? (0:47)
5. When are Intrapartum Antimicrobial Prophylaxis IAP administered
6. VIDEO: How are Intrapartum Antimicrobial Prophylaxis (IAP) administered? (1:19)
7. Which antibiotic at what dosage?
8. VIDEO: What if a mother is allergic to penicillin? (0:43)
9. Severe reaction to penicillin (anaphylaxis)
10. VIDEO: Risk of serious anaphylactic allergic reaction to antibiotics? (1:03)
11. Observe baby rather than IAP
12. VIDEO: Observe baby rather than IAP (1:07)
13. Session Five: Science References
14. Session Five: Graded Test
15. Session Five Downloadable Handouts
16. Session Five: Discussion Forum

PART TWO: GUIDELINES FOR UK, USA, CANADA, AUSTRALIA AND NEW ZEALAND

1. Session Six Learning Objectives
2. Session 6: Updates and Disclaimer
3. Session Six: Reminder of clinical terms

Session 6: Guidelines for UK

6a UK RCOG Green–top Guideline No. 36 2017 - Summary of some points from guidelines
6b. UK RCOG Green–top Guideline No. 36 2017 - List of clinical risk-factors
6c. UK RCOG Green–top Guideline No. 36 2017 - Explanation of antibiotic dosage
6d. UK RCOG Green–top Guideline No. 36 2017 - Summary of risk-based approach if mother is in labour
6e. UK RCOG Green–top Guideline No. 36 2017 - Induction membrane sweeping or Caesarean
6f. UK RCOG Green–top Guideline No. 36 2017 -Summary after baby is born
Session 6: Downloads for Guidelines for UK

Session 6: Guidelines for USA

6a. USA ACOG 2019 Summary of key points from guidelines
6b USA ACOG 2019 If the prenatal GBS culture is positive
6c USA ACOG 2019 If the prenatal GBS culture result is unknown
6d USA ACOG 2019 If allergic to penicillin
6e USA ACOG 2019 Obstetric interventions should not be delayed
6f USA ACOG 2019 If preterm labour or rupture of membranes before 37 weeks
6g USA ACOG 2019 Summary of when IAP indicated
6h USA ACOG Committee Opinion 797 - Feb 2020
6i USA ACM Guidelines March 2020
6j: USA AAP Clinical Report July 2019
Session 6: Downloads for Guidelines for USA

Session 6: Guidelines for CANADA

6a Canada SOGC 2018 Summary and statement
6b Canada SOGC 2018 Recommendation No. 1 Universal Screening
6c Canada SOGC 2018 Recommendation No. 2 IAP for GBS
6d Canada SOGC 2018 Recommendation No. 3 Preterm or rupture of membranes
6e Canada SOGC 2018 Recommendation No. 4 Intrapartum fever and chorioamnionitis
6f Canada SOGC 2018 Recommendation No. 5 Antibiotic susceptibility testing
6g Canada SOGC 2018 Recommendation No. 6 Term pre-labour rupture of membranes
6h Canada SOGC 2018 Recommendation No. 7 Unknown GBS status at term and ruptured membranes over 18 hours
6i Canada SOGC 2018 Recommendation No. 8 Preterm pre-labour rupture of membranes
6j Canada SOGC 2018 Recommended antibiotic regimens for intrapartum prophylaxis
Session 6: Downloads for Guidelines for CANADA

Session 6: Guidelines for AUSTRALIA AND NEW ZEALAND

6a Australia and New Zealand RANZCOG 2016 Summary of some points in guidelines
6b Australia and New Zealand RANZCOG 2016 guidelines - Flowchart for risk-factor approach
6c Australia and New Zealand RANZCOG 2016 guidelines - Flowchart for Universal Screening
6d Australia and New Zealand RANZCOG 2016 guidelines - Flowchart for Specific Clinical Scenarios
6e Australia and New Zealand RANZCOG 2016 guidelines - Flowchart for antibiotic dosage for IAP and Conclusion
6f New Zealand Consensus 2014 Guideline - Summary of recommendations
6g New Zealand Consensus 2014 Guideline - Management of newborn babies
Session 6: Downloads for Guidelines for AUSTRALIA AND NEW ZEALAND

Session 6: Science references, test and handouts

Session Six Science references
Session Six: Graded Test
Session Six: Downloadable Handouts
Session Six: Discussion Forum

Session 7: Two Small Studies On The Impact Of Intrapartum Antimicrobial Prophylaxis (IAP) On The Infant Microbiome

1. Session Seven Learning Objectives
2. VIDEO: General thoughts on the impact of Intrapartum Antibiotic Prophylaxis (IAP) on the infant microbiome (3:38)
3. Two small studies comparing impact of IAP on infant gut microbiome
4. VIDEO: Impact of IAP on infants at 3 months of age in the CHILD study (2016) (2:53)
5. Findings of Canadian CHILD Study (2016)
6. VIDEO: CHILD Study (2016): Maternal antibiotics associated with decrease of Bacteroidetes (2:08)
7. Canadian CHILD study - Age 3 months, different bacterial pattern after exposure to maternal IV antibiotics
8. VIDEO: Child health implications of maternal IAP – Risk of food sensitisation? (1:29)
9. CHILD Study (2016) Increased risk of food sensitisation
10. VIDEO: Summary of findings of CHILD Study (2016):IAP and increased risk for food sensitisation (2:13)
11.Session Seven: Science references
12. Session Seven: Graded Test
14. Session Seven: Downloadable Handouts
15. Session Seven: Discussion Forum

Session 8: Evidence For Other Strategies To Prevent GBS Infections

1. Session Eight Learning Objectives
2. VIDEO: IAP for every pregnant woman (1:19)
3. IAP for every pregnant woman
4. VIDEO: Eradicating GBS carriage during pregnancy? (2:24)
5. Can GBS carriage be eradicated?
6. VIDEO: Can probiotics reduce GBS colonisation? (0:57)
7. Do probiotics reduce GBS colonisation?
8. Session Eight Science references
9. Session Eight: Graded Test
10. Session Eight: Downloadable Handouts
11. Session Eight: Discussion Forum

Session 9: GBS and Breastfeeding

1. Session Nine: Learning Objectives
2. VIDEO: How does breastfeeding impact GBS? (2:01)
3. Can breastfeeding modify changes from maternal IV antibiotics given before birth?
4. VIDEO: Can breastfeeding help ‘restore’ the compositional changes in the infant microbiome? (2:42)
5. Could breast milk help prevent GBS infection in babies?
6. VIDEO: Summary of impact of breastfeeding after exposure to antibiotics (0:49)
7. Session Nine: Science references
8. Session Nine: Graded Test
9. Session Nine: Downloadable Handouts & Extra Reading
10. Session Nine: Discussion Forum

Session 10: Potential For A Future Vaccine To Prevent GBS Infections

1. Session Ten Learning Objectives
2. VIDEO: Possibility of a vaccine to prevent GBS infections? (2:47)
3. Maternal vaccines for Pertussis, Neonatal Tetanus, Respiratory Synctial Virus (RSV) and Pneumonia
4. VIDEO: Could a vaccine help prevent GBS infections? (1:52)
5. A maternal vaccine for GBS
6. VIDEO: Progress with GBS vaccine research (5:25)
7. IV antibiotics would still be needed
8. VIDEO: How soon could a GBS vaccine be ready? (2:02)
9. GBS vaccines in development
10. VIDEO: What is your take-home message? (2:03)
11. Session Ten Science references
12. Session Ten: Graded Test
13. Session Ten: Downloadable Handouts
14. Session Ten: Discussion Forum

Session 11: Downloadable Handouts, Student Evaluation and Certificate of Completion

1. Session Eleven: Course Downloadable Handouts
2. Group B Strep (GBS) Online Course: Student Evaluation Form
3. Group B Strep (GBS) Online Course: Discussion Forum
4. Group B Strep (GBS) Online Course: Certificate of Completion
4b. Midwifery Council (New Zealand) - Certificate of Completion, Reflection Forms, Course Schedule and Reference List

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