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Mourning Sarah a case for testing group B strep

The author uses a personal tragedy to make an impassioned, but one-sided, case for the introduction of screening in the UK

The author uses a personal tragedy to make an impassioned, but one-sided, case for the introduction of screening in the UK

This book is a true story of a woman's painful journey in losing a baby to group B strep infection.

Theresa Huttlinger Vigour has produced an honest, deeply personal account, which conveys the tragic circumstances of her daughter's premature death from a potentially preventable illness.

The narrative starts with the author's joy at discovering she is pregnant after several miscarriages. The baby is desperately wanted, and Huttlinger Vigour follows all the medical advice given in order to deliver a healthy baby.

The pregnancy progresses smoothly, until she notices fluid loss, which she believes to be amniotic fluid, 11 days before her due date.

Surprisingly, she is advised by her obstetrician by telephone that this is probably urine leaking, and not to worry about it.

The following morning, her husband contacts the obstetrician again to clarify whether his wife should go into hospital.

The obstetrician acknowledges that it probably is amniotic fluid leaking, and states that after 24 hours there is a risk of infection.

He does not seem to convey any sense of urgency, however; hence Hutlinger Vigour decides to wait a little bit longer for contractions to start naturally.

Eventually, the following evening, she goes into labour, but 18 hours after the birth, baby Sarah develops pneumonia, and sadly dies.

This book raises awareness of group B strep infection, and the catastrophic consequences that can occur if it is undetected.

It is aimed towards patients, and comes across as the author's way of campaigning to raise the profile of this potentially lethal infection.

The narrative is not only about group B strep, but also about bereavement and coping with the loss of a much-wanted child.

There is obvious anger from Huttlinger Vigour, and this is directed mainly towards the medical profession.

There is anger at the fact that she was not screened for group B strep during her pregnancy, and also anger at the way in which the medical staff handled her whole case.

The devastating news of her baby's death for instance is broken to her by her neonatologist. When she asks the neonatologist why her baby died, he tells her: ‘You didn't come to the hospital soon enough.'

The downside to this book is that it does not give enough information about group B strep infection and the lack of evidence for screening in the UK.

Huttinger Vigour mentions at the end of the book that there is now an established screening programme in the US, which enables pregnant women to have a swab test for group B between 35-37 weeks.

She also goes on to write that since an active screening programme was started in the mid 1990s, the rate of neonatal group B strep infections in the US has declined by 70%.

Unfortunately, the book does not discuss that there is conflicting evidence with regards to group B strep screening; for instance, some pregnant women may be given antibiotics unnecessarily, which could potentially increase rates of severe allergic reactions and antibiotic resistance.

For these reasons, group B strep infection screening in pregnant women is not currently recommended in the UK.

I would recommend this to women who are thinking of becoming pregnant, and also to health professionals, as it opens up the debate regarding group B screening in pregnancy.

Dr Tahmeena Farid

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