Newborn examination on full-term neonate whose mother had group B streptococcus colonisation

This article presents a case report of a newborn infant physical examination (NIPE) performed while the author was studying for the post-registration NIPE qualification as caseloading midwife. The author examined infants in the community-either homebirths or infants that had been discharged from hospital. One neonate examined was born at 40 weeks' gestation to a woman identified as having group B streptococcus colonisation at 36 weeks' gestation. The woman declined birth in hospital with intrapartum antibiotics, choosing instead to birth at home. This case is used to reflect on current practices regarding the management of women colonised with group B streptococcus, and on the NIPE screening programme. The rationale for the NIPE is addressed, alongside the midwife's role and the importance of the timing of the NIPE. The evidence surrounding the management of group B streptococcus and the potential impact on the neonate is examined. All components of the general physical examination as outlined by the UK National Screening Committee were assessed, but the case study focuses on issues pertinent to a full-term healthy newborn born to a woman with group B streptococcus. It critically evaluates the relevant neurobehavioural and physiological assessments, in order that normal can be assumed or deviation from the norm identified. The techniques and tools for assessment are discussed alongside professional, legal and ethical implications.