Urinary tract infection (UTI) is common, can be both symptomatic and asymptomatic, and can lead to adverse pregnancy outcomes, both maternal and of the baby.
- UTI can cause further impairment of any underlying renal disease during pregnancy, particularly if not promptly detected and treated.
- UTI is found in about 8 – 10% of all pregnancy.
- Most individuals with UTI are found to have bacterial counts of more than 104-105/ml of is used as the diagnostic criterion. Lower counts suggest contamination and a repeat sample of a clean-catch midstream specimen is required.
- When more than one strain of bacterial pathogen is found, this is more likely due to a contamination rather than true UTI.
- UTI can manifest as:2
- à Asymptomatic bacteriuria (in 2-5% of pregnancies)
- à Acute cystitis (about2% of pregnancies)
- à Acute pyelonephritis (in 2% of pregnancies, with a recurrence rate of up to 25% in the same pregnancy).
- Well-recognized physiological changes as w3ell as the modified immune status of pregnancy aid the development of UTI.
- Most UTIs caused by Gram-negative aerobes from the gastrointestinal tract. Escherichia coli account for 80-90% of UTI, follow4edj by Staphylococcus saprophytic us, Staph, aurues, and the Gram-positive GBS.
- B. Treatment is therefore recomended3 with appropriate antibiotics for a minimum 7 days.
- Post-treatment completion follow-up cultures are recommended to ensure clearance of asymptomatic bacteriuria. repeat follow-up cultures may need to be performed once in each trimester in women identified to have asymptomatic bacteriuria in the first-trimester screening sample.4
CONTACT: Dr. Sharda Jain -9650511339
Dr. Jyoti Agarwal -9910081484
Asymptomatic bacteriuria in Pregnancy
- One-third of women with asymptomatic bacteriuria will go on to develop acute cystitis during pregnancy
- This is associated with increased rates of subsequent pyelonephritis (in nearly one-third), anaemia, preterm labour (in about 13%), low birth weight, chorioamnionitis, increased perinatal mortality, developmental problems in baby etc.
- Screening with active treatment is shown to significantly reduce these risks.
- Routine midstream urine (MSU) screening for asymptomatic bacteriuria at the first booking visit is part of routine antenatal practice in the west, applicable to all pregnancies.
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