<div style="text-align: center;">What is the next best step in a pregnant woman GBS (+) at 36-38 weeks undergoing planned cesarean birth?</div><br><div style="text-align: center;">{{c1::No GBS prophylaxis required}}</div>

ACOG guidelines: Intrapartum prophylaxis that is specific for GBS is not recommended for women undergoing a planned cesarean birth in the absence of labor and rupture of membranes, regardless of the gestational age, even among women who are GBS positive.

<i>ACOG guidelines: </i>Intrapartum prophylaxis that is specific for GBS is&nbsp;<b>not recommended</b>&nbsp;for women undergoing a planned cesarean birth in the absence of labor and rupture of membranes, regardless of the gestational age, even among women who are GBS positive.<br><br><div>-Neonaltal GBS EOD occurs at a very low rate in this situation (approximately 3 per 1,000,000 live births)&nbsp;</div><div>- Women undergoing cesarean birth (regardless of GBS colonization status) be administered one dose of prophylactic antibiotics (eg cefazolin + azythromycin) before the incision to reduce the risk of postoperative infections&nbsp;</div><div>-planned cesarean birth patients should nonetheless undergo prenatal GBS culture 36-38 weeks of gestation b/c labor or rupture of membranes may occur before the planned cesarean can be performed.&nbsp;</div><div>- planned cesarean birth and a positive antepartum GBS culture present in active labor or with PROM before her scheduled delivery date GBS prophylaxis and presurgical prophylaxis appropriate (eg. Cefazolin to cover both prophylacitc requirements)</div><div>-Delaying the cesarean birth to administer additional doses of antibiotics for GBS prophylaxis alone is not indicated.</div><br><div><a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns#:~:text=Intrapartum prophylaxis that is specific,women who are GBS positive.">https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns#:~:text=Intrapartum prophylaxis that is specific,women who are GBS positive.</a><br></div>