It is estimated that at least 15% of adult healthy women have a Group B Strep bacteria colonization that can be transferred to their baby during childbirth. The majority of these women do not exhibit any symptoms. On average, at least 1 out of every 200 babies born to a mother with the Group B Strep bacteria will develop the infection.
Newborns are especially at risk if they develop the infection as it can lead to pneumonia, sepsis, and even meningitis. These can leave the child with severe permanent problems, including blindness, deafness, seizures, developmental delays and brain damage.
Administering antibiotics during labor substantially reduces the likelihood that the mother will transfer the bacteria to her baby. Given the risk to newborns most doctors agree that antibiotics should be administered to all pregnant women who have a history of the bacteria earlier in the pregnancy or a prior pregnancy. They also generally agree that all other pregnant women should generally be screened for the presence of the bacteria between weeks 35 and 37 of the pregnancy even if they have no symptoms.
The test is normally performed with a swap and the samples are processed in a laboratory in an enriched culture medium. The results of the test are typically available in 24 to 48 hours. A positive test result should be followed by treatment with antibiotics during labor.
Sometimes doctors fail to follow this protocol with tragic consequences. Consider, for example:
A situation in which a pregnant woman was admitted to the hospital for labor and delivery. The woman's history included (1) a Group B Strep infection at week 32 of the pregnancy, (2) the spontaneous rupture of membranes during weeks 36 and 37 of the pregnancy and (3) a fever during labor and delivery. Considering these three factors the doctor should have administered appropriate antibiotics. The rupture of membranes can lead to a heightened risk of infection especially if longer than 24 hours have passed since the rupture. A fever is a sign of infection. And the woman had already been noted to have Group B Strep earlier in the pregnancy. Three signs all pointing in the same direction. A clear protocol and yet the doctor did not administer antibiotics during labor.
Finally, fetal monitoring showed variable decelerations. Variable decelerations are a sign that the unborn baby is in fetal distress. This was the fourth and final sign. At this point the doctor delivered the baby via C-section. But the baby developed a Group B Strep infection shortly after birth. The result - the child had learning disabilities. This was an actual case and the law firm that handled this matter reported that the case settled after mediation for $962,000.
If prophylactic antibiotics are not administered to a mother who had a prior history of colonization or was not screened her newborn baby is at risk of getting the Group B Strep infection. The baby needs to be carefully monitored, especially for the first 24 hours after being born. The majority of early onset cases occur during this time frame. Fever, difficulty breathing, limpness, lethargy, stiffness and seizures are among some of the signs that the baby has the infection. Should the baby exhibit signs of the infection antibiotics can be administered and a full diagnostic workup conducted. Any delay in treatment increases the chances that the baby will suffer from pneumonia, sepsis, and even meningitis. If the baby survives the result can be devastating lifelong disabilities.
The case discussed above is an example of a series of medical errors that resulted in just such an injury to the baby. As the case illustrates, when a doctor commits such errors, fails to implement the appropriate protocols, and thus provides care that is below medical standard of care, the doctor may be liable for medical malpractice. The case further illustrates that recovery under such circumstances can be substantial.
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