A Urinary TRACT IN PREGNANCY

 

 

Urinary TRACT IN PREGNANCYUrinary 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.
  1. 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

http://www.drshardajain.com/

http://www.lifecarecentre.in

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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