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Given at least 4 hours before delivery when possible (and continued until delivery), administer IV antibiotic prophylaxis after consultation with a physician.The most common antibiotic regimen for intrapartum prophylaxis is: In Canada, the prevalence of GDM is higher than previously thought -- 3.7% in the non-Aboriginal population and 8-18% in Aboriginal population.Integrated prenatal screening (between 11-14 weeks and 15-20 weeks) and/or maternal serum screening (between 15-20 weeks' gestational age) is to be offered if available and if the woman qualifies for testing in your province/region (for example, women who have had a previous child with an anomaly, or are of advanced maternal age).All women in Canada have a right to be informed about the available tests to predict fetal anomalies (for example, congenital malformations, chromosomal abnormalities) and should receive information related to the available testing.Also, clients with a history of poor compliance to medications and additional lifestyle issues such as variable diet or possible teratogenic substance use (for example, alcohol, tobacco, recreational nonprescription drugs) should also have their case discussed with a physician.
Neonatal transmission may occur when the neonate passes through the vaginal canal, when the infection ascends the maternal genital system, or when the neonate aspirates bacteria-infected amniotic fluid.
Without maternal intrapartum antibiotic treatment, neonatal GBS transmission occurs approximately 50% of the time.
Of those neonates colonized by GBS, 1-2% will develop early-onset GBS disease.
Thereafter, consult a physician if: failure to gain weight or weight loss present; client is symptomatic; pre-meal glucose levels cannot be maintained below 5.3 mmol/L within 2 weeks of treatment with nutrition therapy; or any complications are identified.
All women with GDM should have a 75 g oral GTT between 6 weeks and 6 months postpartum and when planning a future pregnancy to rule out type 2 diabetes.Arrange a consultation with the physician once per trimester if possible and as necessary if an abnormality is identified or suspected.Attempt to have final prenatal visit coincide with physician visit.The remainder of the information is only related to early-onset GBS disease.