What is it about?
Large population studies have failed to detect an association between multiple gestations and GBS infection. However, they represent an interesting model because different fetuses are simultaneously exposed to the same maternal influences but may have a very different outcome. Intrauterine infection may occur in each member of a monozygotic pair, only in one (discordant infection) or in both members of a dizygotic pair. Discordant GBS infections are rarely documented and mostly reported in dichorionic/diamniotic twins; more frequently they occur in the sac nearest the cervix because of the ascending route of transmission. The infection of the non-presenting twin (co-twin) may be caused by trans membraneous invasion from the presenting sac or by hematogenous spread. We describe two cases of gestational Group B Streptococcal infection in twin pregnancies (a monochorionic/diamniotic and a dichorionic /diamniotic pregnancy), both resulting in the death of one twin.
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Why is it important?
Despite the ubiquity of Group B Streptococcus (GBS), only a few cases documenting twin gestational GBS infections have been reported.
Perspectives
Twin pregnancies compared to singleton pregnancies are more likely not to reach full-term since the uterine overdistension leads to premature cervical dilatation and induces the activation of the mechanism of labur. They should immediately receive intrapartum antibiotic prophylaxis if the GBS culture is positive. In order to reduce the rate of perinatal morbidity and mortality in the context of multiple pregnancies, a strict adherence to CDC guidelines is recommended.
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This page is a summary of: Gestational group B streptococcal infection in two twin pregnancies, Case Reports in Perinatal Medicine, March 2017, De Gruyter,
DOI: 10.1515/crpm-2016-0043.
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