North American Registry of Midwives (NARM) Practice Exam

Under what circumstances are IV antibiotics advised for a GBS positive client?

1. During labor if it's preterm or the mother has hypertension

2. Only if the mother has a history of GBS infections

3. During labor if membranes are ruptured for more than 18 hours

4. Only after delivery if infection is detected

The correct answer is: During labor if membranes are ruptured for more than 18 hours

In the context of Group B Streptococcus (GBS) management during pregnancy and labor, administering intravenous (IV) antibiotics is crucial in certain situations to prevent early-onset GBS disease in newborns. The correct circumstance for administering IV antibiotics is during labor if the membranes are ruptured for more than 18 hours. When the membranes rupture, it creates an opportunity for GBS bacteria to enter the amniotic fluid and potentially infect the newborn. The risk of infection increases significantly if there has been a prolonged period (more than 18 hours) between rupture of membranes and delivery. This is why continuous monitoring for GBS-positive mothers is essential during labor, especially if they experience prolonged rupture of membranes. In cases of GBS-positive status, the administration of IV antibiotics plays a critical role in safeguarding the infant from potential infection. Immediate response to this situation is necessary to ensure the health and safety of both mother and infant, aligning with established clinical guidelines on the management of GBS during delivery.