Strep Throat During Pregnancy

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Streptococcal pharyngitis (strep throat) is a bacterial infection. It is caused by bacteria called beta hemolytic streptococcus. There are many members of this bacteria family. The type that causes strep throat is group A. Other than making you sick and tired, strep throat should have no effect on your pregnancy or your baby.

If you Google streptococcus, do not confuse strep A infection with group B streptococcus. Group B does cause an infection that can be dangerous for your baby. These bacteria live in your rectum or vagina and they can be passed to a baby during a vaginal delivery. Your pregnancy care provider usually checks for these bacteria in the 35th or 36th week of pregnancy.

Signs and Symptoms of Strep Throat

Strep throat causes a bad sore throat. The symptoms start quickly. Strep throat is about one tenth as common as a viral sore throat. It is most common in the spring and winter. It is passed from person to person the same way cold and flu viruses spread, by close contact with nasal and oral secretions. Strep throat may start in 2 to 5 days after you come in contact with the bacteria.

Step throat does not usually cause symptoms of cough or nasal congestion like a cold or flu virus. The most common signs and symptoms in adults are:

  • Very sore throat
  • Painful swallowing
  • Fever
  • Headache
  • Swollen glands (lymph nodes) in the neck
  • Red, swollen throat and tonsils, that may have white spots

Less commonly, there may also be a red (scarlet) skin rash, called scarlet fever. Strep throat can look a lot like a viral pharyngitis. It can’t be diagnosed just by looking at your tonsils. To make the diagnosis, your health care provider should do a throat swab to check for the bacteria.

Treatment for Strep Throat

Unlike a viral sore throat, which should not be treated with an antibiotic, strep throat does need to be treated. The reason for treatment is that an antibiotic kills the bacteria quickly, decreases the risk of spreading the infection to others, and prevents complications. Complications were common and sometimes deadly in the days before antibiotics.

The good news is that good old penicillin can stop a strep throat as quickly as it started. To this day (fingers crossed), there have been no reports of group A strep becoming resistant to penicillin. Untreated strep throat can spread to your ears and infect the bone behind the ear, an infection called mastoiditis. In the days before penicillin, mastoiditis was a frequent cause of hearing loss and could be deadly if bacteria spread to the brain. Today mastoiditis is very rare. Another complication is peritonsillar abscess, which may require surgical drainage and removal of the tonsils. Rheumatic fever is another complication of strep throat rarely seen today. It is caused by an immune system reaction to the infection. Rheumatic fever can damage the heart and the joints.

The most common treatment for strep throat is 10 days of oral penicillin or amoxicillin. Another option is a single injection (into a muscle) of a large dose of penicillin. If you are allergic to penicillin, another antibiotic, usually cephalosporin can be used.

What to Do

If you have a sudden onset of sore throat and fever, let your health care provider know. If a swab test shows strep throat, take your antibiotics as directed. Take the whole dose. Don’t stop if you feel better. To prevent spreading strep to someone else, stay home and rest until at least 24 hours after you start your antibiotic and your fever is gone. The best way to prevent strep throat is to wash your hands frequently. Avoiding crowds, sick people, and tightly packed places will help you avoid strep throat as well as the much more common viruses during cold and flu season.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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