Strep throat is a common bacterial infection caused by the bacterium Streptococcus pyogenes (Group A Strep). When this infection occurs during pregnancy, it requires immediate attention and treatment. While strep throat is not generally considered more severe in pregnant people, the potential complications of an untreated infection make prompt medical consultation necessary. Rapid diagnosis and the use of pregnancy-safe antibiotics are essential to manage the condition and protect both the pregnant person and the developing fetus.
Identifying Strep Throat During Pregnancy
Strep throat symptoms in a pregnant person are the same as those experienced by anyone else. The onset is often sudden, featuring a sore throat that causes pain when swallowing. Common signs include a fever (sometimes reaching 100.4°F or higher), swollen tonsils that may show white patches or pus, and swollen lymph nodes in the neck. Tiny red spots, known as petechiae, may also be visible on the roof of the mouth.
Unlike a common cold, strep throat typically lacks a cough, runny nose, or nasal congestion. However, clinical observation alone is insufficient for a diagnosis because symptoms can overlap with other viral infections. An accurate diagnosis relies on a medical professional performing either a rapid strep test or a throat culture to detect Streptococcus pyogenes.
Immediate Risks of Untreated Strep
Untreated Group A Strep infection carries specific risks that necessitate prompt antibiotic therapy. The primary concern is the infection becoming systemic, which can lead to serious, though rare, complications. These include acute rheumatic fever, which can damage the heart valves, and post-streptococcal glomerulonephritis, a type of kidney inflammation.
Systemic infection can progress to sepsis, a life-threatening response that could affect the pregnancy. A high maternal fever, a common symptom of severe infection, has been linked to adverse pregnancy outcomes, particularly if it occurs early in gestation. While Group A Strep is distinct from Group B Strep (GBS), any severe maternal infection warrants close monitoring to prevent complications such as preterm labor or premature rupture of membranes (PPROM).
Safe and Recommended Treatment Protocols
The standard of care for treating strep throat in pregnant patients is a course of antibiotics to eliminate the bacteria and prevent serious complications. Penicillin and Amoxicillin are the first-line treatments because they are highly effective against Group A Strep. They are classified as Pregnancy Category B drugs, meaning animal studies have not shown harm to the fetus, making them safe throughout all trimesters.
For individuals with a known penicillin allergy, safe alternatives are available. Certain cephalosporins, such as cephalexin, are often prescribed and considered safe during pregnancy. If a cephalosporin cannot be used, a macrolide antibiotic like Azithromycin or Erythromycin may be an option, managed carefully by the healthcare provider.
It is necessary to complete the entire course of antibiotics prescribed, even if symptoms improve quickly. Stopping treatment early risks the infection recurring and increases the potential for serious complications. If symptoms do not improve within 24 to 48 hours of starting the medication, the patient should contact their doctor for a follow-up assessment.
Preventing the Spread of Strep
A pregnant person diagnosed with strep throat should take steps to prevent the infection from spreading to household members. The bacteria is highly contagious and transmits through respiratory droplets released when an infected person coughs or sneezes. Covering the mouth and nose with a tissue or the elbow when coughing or sneezing is an effective measure.
Frequent handwashing with soap and water for at least 20 seconds is a primary defense against transmission. It is important to avoid sharing personal items, such as utensils, drinking glasses, food, and toothbrushes. The infected person should minimize close contact with others and remain home from work or school until they have been on antibiotics for a full 24 hours and their fever has resolved.