What are the intrapartum GBS risk factors requiring treatment for a woman with unknown GBS status?

Amniotic membrane rupture lasting more than 18 hours is a significant risk factor for the development of early-onset Group B Streptococcus (GBS) infection in newborns when the maternal GBS status is unknown. When the membranes are ruptured for an extended period, it creates an increased risk of bacteria, including GBS, ascending from the cervix into the uterus. This prolonged exposure can lead to the colonization of the fetus during labor and delivery, making the use of intrapartum antibiotic prophylaxis crucial in these circumstances to mitigate the risk of infection.

In determining the need for antibiotic treatment during labor, it's essential to consider the timing of membrane rupture. A rupture that occurs beyond 18 hours is seen as a more significant risk factor because of the increased likelihood of infection transmission to the infant. Therefore, this guideline underscores the importance of timely intervention in labor management for patients with unknown GBS status, particularly in the event of prolonged rupture of membranes.