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



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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