Don't test, tell

Back in January, I wrote in the blog about Screening for Group A Strep (GAS). Since then I have thought about it a lot, and discussed it with various medical professionals.

I am convinced it is a worthless exercise. Worse than that, it could be dangerous. Why?

A woman can be colonised with GAS at any point in her life*, let alone in her pregnancy or puerperum, so all a test would do is say that she does or does not carry the bacteria at this very point in time.

What if she was colonised the day after the test? She would have been given a false sense of security by a negative result. If GAS was only introduced some time after delivery, and it caused a genital tract sepsis, the last thing on her mind would be childbed fever, because she was 'clear'.

It is of far more value to skip the testing and instead take every woman's temperature and pulse regularly in the days after delivery. Then tell her about the condition and how to recognise that she might have it. She must also be told of the vital importance of being seen, swabbed and treated if infection is suspected, before her health and her life are in danger.

* up to 30% of us may be carrying Group A Strep in our throats or on our skin