Preterm Labor (GBS) 22 weeks, HELP?

Patient

Q: Hello, I have a question regarding my preterm labor. I am 23 years old, and I was 22 weeks pregnant with my baby. My due date was December 2, 2014. On 7/28/14 I went to the doctor for blood work results and everything seemed fine. I took a urine test that day as well. On August 1, 2014 I started experiencing really painful cramps and discharge with a small amount of blood. I called and the nurse told me that this happens sometimes and since my medical history seemed normal to not worry if it hurt more to come in. Well, it did. I came in to the ER at night with painful contractions and had to wait an hour and a half or so before I was seen. By then i was bleeding a lot more. When the doctor checked me he said I was 6 cm dilated and had a bulging bag of water due to an infection. I was confused because I was never told I had one to begin with. My baby was born 1 lb 1 oz, with a heartbeat. They told me he wouldn't make it so they cleaned him and gave him to me to hold without trying to resuscitate him at all. I had complications getting my placenta out but finally it came out and a day later I came home. When I got home I checked my online portal with the hospital that has all my medical records and any blood work results. I realized that on 7/29/14 my account was noted and it stated "GBS (group B streptococcus) UTI complicating pregnancy" Now I know what infection the doctor was talking about. My question is, had I known since the 29th of July days before i unfortunately went into labor, could I have possibly saved my baby? Is there even a treatment for GBS, weren't the doctors supposed to contact me to treat me? They also told me the day i was discharged from the hospital that i have a heart shaped uterus and that also could have affected the baby. I just don't understand why I wasn't told before. Maybe this could have been prevented. Other than that all my blood work was normal. I was never considered high risk. Please help! I'm just looking for answers.

Symptoms:  Pregnant, discharge, blood, cramps
Doctor

A:   Asymptomatic bacteria in the urine called as asymptomatic bacteriuria in pregnancy is associated with an increased risk of acute pyelonephritis as well as preterm labour and low birth weight babies. It is therefore a WHO recommendation that antibiotic therapy be offered for the treatment of the same.
Although enterococcus is the most common bacterial urinary tract infection, GBS is seen in roughly 40percent cases. Having GBS urinary tract infection does increase risk of preterm delivery and antibiotics may have prevented your loss. However it may not have been the only cause of the preterm labour as a lot of other factors can cause second trimester losses.
Arcuate or heart shaped uterus may also predispose women to miscarriages and there is a lot of controversy amongst doctors on whether it requires any preventive corrective surgery before any losses have occurred.
For the future pregnancies, I would recommend that you have an early antenatal screening for urine infections as GBS infection is known to recur. You may also need a hysteroscopic surgery to evaluate the cavity of the uterus before you conceive again to prevent any losses.
Although I can understand that you are grief-stricken at present, it would be a good time to discuss the plan of action to avoid recurrent miscarriages with your obstetrician. It may also be a good time to have an honest discussion with your doctor whether or not there has been any mismanagement in your case before you come to any conclusion regarding the same.

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