Risk factors of UTI in pregnant women and the maternal and perinatal outcome in pregnant women (original) (raw)
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Scholars Journal of Applied Medical Sciences, 2020
Original Research Article Objective: In this study was designed to see the risk factors of UTI in pregnant women and the maternal and perinatal outcome in pregnant women attending CMaH Dhaka. Methods: In this case control study, women enrolled in antenatal OPD of CMH Dhaka during July, 2016 to December 2016, were randomly allocated into case and control group. The inclusion criteria for pregnant women during the 13 th-26 th weeks of pregnancy in the case group was the positive urine cultures of bacteria (more than 10 5 colonies growth in a standard positive urine culture). The same with negative culture was control group. Then parameters such as parity, sexual activity, type of delivery, and infants' birth weight were recorded in questionnaire. Results: Incidence of UTI in mid trimester pregnancy during study period was 26%. Risk factors like previous history of UTI, sexual activity and multipara were higher in case group. Highest age incidence was between 20-30 years. Predominantly patients were asymptomatic. Lower abdominal pain was a common symptoms. Eshcherichia coli was commonest organism. Prevalence of bacteriuria was more in women with history of UTI earlier in pregnancy. Premature rupture of membrane was significantly higher in case group. Caesarean section was higher in the case group. According to this study, the average weight of newborns whose mothers had UTI was 2.83 kg and it was 0.44 kg lower than the newborns of healthy mothers. Conclusion: According to the conducted study, UTI in mothers is the major reason for comparatively lower birth weight of infants. Routine urine check up during pregnancy helps to diagnose this early and prompt treatment is beneficial for infant.
IMPORTANCE OF EARLY DIAGNOSIS OF URINARY TRACT INFECTION IN PREGNANT WOMEN IN PREVENTING PREMATURE BIRTH (Atena Editora), 2024
INTRODUCTION: Pregnancy is a period of intense anatomical changes, which can contribute to an increase in urinary infections1,4,5. This, if complicated, can lead to premature birth1,2,3,4. That said, early diagnosis is important, and consequently early treatment, to avoid this unfavorable outcome4,5. OBJECTIVE: Describe the pathophysiological mechanism of urinary infection in pregnant women that can lead to premature birth and discuss the importance of early diagnosis in this situation. METHODOLOGY: Literary review, searching for scientific productions in the Scielo database and protocol of the Brazilian Federation of Gynecology and Obstetrics Associations of publications from 2008 to 2021, with restricted Portuguese language, through the descriptors “Urinary infection in pregnancy”, “Urinary infections”, “Infectious complications in pregnancy” and “Prenatal care and urinary tract infection”. RESULTS AND DISCUSSION: Pregnancy is a period of bodily changes due to biochemical, endocrine-metabolic and mechanical factors, resulting from the relaxing action of prostacyclin and progesterone, the physiological increase in renal plasma flow and uterine dextrorotation, causing compressive mechanical action on the urinary tract 1,2, 4.5. These changes will lead to urinary stasis, concentrated in nutrients, favoring the proliferation of microorganisms and infection4. The most common bacteria are Escherichia coli, Enterobacter sp., Klebsiella sp., Pseudomonas sp., Group B Streptococcus, among others, but the first is more prevalent1,4,5. Some patients have no symptoms, however, if not diagnosed and treated, they can progress to symptomatic forms, such as cystitis or pyelonephritis2. During infection, the production of chemocytokines and phospholipases A2 and C will occur, in addition to the colonization of amniotic fluid, which activate prostaglandins E2 and F2-alpha that initiate labor3,4. Prenatal screening must be carried out for early detection of the asymptomatic form, using urine culture, which is the gold standard test2,3,4. You can also request a urinalysis, nitrite test, leukocyte esterase and urinary tract ultrasound4. The purpose of early detection is to prevent the infection from becoming more complicated and leading to premature birth4,5.CONCLUSION: Given the high frequency of urinary infections during pregnancy, due to changes in the woman's body, and the complication of premature birth, shows the importance of early detection so that appropriate treatment can begin1,2,4,5. Its diagnosis is clinical and with complementary tests, such as urine culture2,4. Asymptomatic pregnant women are also subjected to screening tests as prophylaxis for premature labor4.
URINARY TRACT INFECTION IN HIGH RISK PREGNANT WOMEN
Background: In this study, we aimed to verify the frequency of urinary tract infection (UTI) in pregnant women, the main etiologic agents and their antibiotic susceptibilities. Moreover, to confirm UTI as a risk factor for maternal and fetal complications. Methodology: Data collection was performed using medical records from pregnant women suffering from UTIs (the Study Group) and pregnant women without UTIs (the Control Group). Both groups of patients visited the Department of High Risk Pregnancy, University Hospital, Federal University of Mato Grosso do Sul during the period of April 2005 to April 2010. Results: Of the 864 pregnant women studied, 15.6% (135/864) had a UTI. Escherichia coli was the most frequent cause of urinary tract infections, with a frequency of 34.8% (47/135). The E. coli strains were most sensitive to norfloxacin (91.4%), nitrofurantoin (80.8%) and ceftriaxone (74.4%) and most resistant to ampicillin (42.5%), trimethoprim-sulfamethoxazole (31.1%) and first-generation cephalosporins (14.8%). There was a significant association between preterm delivery, low birth weight and UTI in pregnant women. There was no significant association with premature rupture of membranes, admission to Neonatal Intensive Care Unit (Neo ICU) and Apgar of less than 7 at 5 min. Conclusion: The use of urine culture as routine prenatal laboratorial screening allows for the early diagnosis and treatment of UTIs in pregnant women, thereby providing better perinatal conditions.
Prevalence of UTI among Pregnant Women and Its Complications in Newborns
Indian Journal of Pharmacy Practice, 2017
Urinary Tract Infections (UTI) are mainly caused by the presence and growth of microorganisms in the urinary tract, which are the single commonest bacterial infections of all age groups and especially in pregnancy. The main objective of this study is to determine the Prevalence of UTI among pregnant women and complications in their newborns. An observational study was carried out over a period of 6 months. A total of 120 pregnant women were enrolled .UTI was diagnosed based on urinalysis reports. With the help of data collection form demographic data were collected. Out of 120 pregnant women, 35% of them had urinary tract infection. It is mostly observed high in age group of <25yrs, Primigravida, winter season and during Third trimester of pregnancy. The commonest causative organism was found to be E.coli (50%).The weight of newborn infants of mothers afflicted with UTI were significantly not lowered compared to newborns of healthy women. The prevalence rate of urinary tract infection (UTI) during pregnancy is high. So it is important to do routine screening of all pregnant women for significant bacteriuria to reduce the complications on both maternal and fetal health.
Urinary tract infection during pregnancy: current concepts on a common multifaceted problem
Journal of Obstetrics and Gynaecology, 2018
Urinary tract infections (UTIs) are the most common bacterial infection in pregnancy, increasing the risk of maternal and neonatal morbidity and mortality. Urinary tract infections may present as asymptomatic bacteriuria, acute cystitis or pyelonephritis. Escherichia coli is the most common pathogen associated with both symptomatic and asymptomatic bacteriuria. If asymptomatic bacteriuria is untreated, up to 30% of mothers develop acute pyelonephritis, with an increased risk of multiple maternal and neonatal complications, such as preeclampsia, preterm birth, intrauterine growth restriction and low birth weight. Urinary tract infection is a common, but preventable cause of pregnancy complications, thus urinary tests, such as urine culture or new technologies such as high-throughput DNA sequence-based analyses, should be used in order to improve antenatal screening of pregnant women.
Urinary tract infection and its effect on outcome of pregnancy
IP Innovative Publication Pvt. Ltd, 2016
Background: Urinary tract infection in pregnancy has been found to be a very common health problem, specially in country like India. The total incidence is 5-10% in pregnancy. This study aims to determine the incidence of UTI in pregnancy, most common microorganism responsible for UTI, most sensitive antibiotics and maternal and fetal outcome. Methods: We randomly select 600 pregnant women, 200 in each trimester, attending outpatient department of Sultania Zanana Hospital, Bhopal, India from the period of October 2013 to September 2014. All pregnant women between 18-35 yrs of age without any medical disorders or previous adverse pregnancy outcomes were in inclusion criteria. Urine culture sensitivity was done as a screening test for UTI. They were followed up till delivery in relation to any pregnancy complication and perinatal outcome. Results: It was found that incidence of UTI was highest in second trimester(15%) and total incidence was 9.8%. The most common maternal morbidity was preterm labour (6.6%) and fetal morbidity was LBW (3.6%). Pregnant women with UTI are susceptible for adverse maternal and fetal outcomes like recurrent infection, chorioamnionitis, PROM, preterm labour, cystitis, pyelonephritis, prematurity, IUGR, LBW, GBS which could be prevented by antimicrobial treatment. Conclusions: From this study, we concluded that every pregnant women should be screened for UTI and urine culture sensitvity should be a part of routine antenatal care. Public educational programmmes on the importance of personal hygiene and good environmental sanitation habits should be carried out frequently.
Risk factors of urinary tract infection in pregnancy
Objectives: To determine the frequency, risk factors and pattern of urinary complaints during pregnancy. Methods: A descriptive study was conducted in the Obstetric and Gynaecology Department of Isra University Hospital, Hyderabad from 1st January to 30th August 2008. Total 232 women were selected to ascertain the frequency and pattern of urinary symptoms as well as the risk factors of urinary tract infection (UTI) such as age, parity, education, past history of UTI and haemoglobin among women attending an antenatal clinic. All pregnant women irrespective of age, parity and gestational age were included, while women with known underlying renal pathology, chronic renal disease, renal transplant, diabetes or taking immunosuppressant therapy were excluded. Informed consent was taken and data collected on a self designed proforma. All the women underwent complete examination of urine. Dipstick test was performed on midstream urine and urine was cultured incase of positive dipstick test and women with urinary symptoms. Data was analyzed on SPSS version 11. Odds ratio and 95% confidence interval were calculated among the categorical parameters by applying the Fisher's exact test. Results: Out of 232 women, 108(46.5%) reported urinary symptoms which were due to pregnancy induced changes on urinary system as no growth was obtained on urine culture, while 10 (4.3%) were due to underlying UTI. Most common urinary symptom in these women was abnormal voiding pattern 85(40.3%) followed by irritative symptoms and voiding difficulties. Illiteracy, history of sexual activity, low socioeconomic (monthly income < Rs. 10,000 / month) group, past history of UTI and multiparity were found to be risk factors for UTI in these women. On complete urine examination, 222 (95.6%) patients either did not reveal any pus cells or had less than 5 WBC/HPF. Out of 108 cultures, only 10 (4.3%) specimens showed growth. E-coli was the most commonly detected organism 7 (3%) followed by S-aureus in 3 (1.3%). Conclusion: The common urinary symptoms encountered in the studied women were abnormal voiding pattern followed by irritative symptoms. Majority of urinary symptoms were due to pregnancy related changes in the urinary system. Past history of UTI, sexual activity, lower socioeconomic group and multi parity were significant risk factors for UTI (JPMA 60:213; 2010).
Global advances in health and medicine : improving healthcare outcomes worldwide, 2013
The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in more developed countries. A global analysis of the etiologies of UTI revealed familiar culprits as well as emerging threats. Screening and treatment of UTI have improved birth outcomes in several more developed countries and would likely improve maternal and neonatal health worldwide. However, challenges of implementation in resource-poor settings must be overcome. We review the nature of the barriers occurring at each step of the screening and treatment pipeline and highlight steps necessary t...
Urinary tract infections at first antenatal check-up: a single centre prospective study
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Pregnant women with asymptomatic bacteriuria (ASB) are more likely to develop acute pyelonephritis, postpartum UTI, hypertensive disease, anemia, prematurity, low birth weight babies and prenatal death if untreated. Methods: Total 780 pregnant women attending for first antenatal checkup in a medical college were enrolled for the study. Those with any symptoms of UTI, like burning micturition, frequency, urgency, dysuria or fever were excluded from the study. All were subjected to undergo urine culture and sensitivity to the commonly used antibiotics in that area, irrespective of period of gestation, age and parity. Prevalence of ASB, most common infecting organism and antibiotic sensitivity pattern were analyzed. Results: The prevalence of ASB in <25 years age group was significantly higher than in >25 years age group (26.06% versus 18.80%; p = 0.020). Out of the 780 culture samples, 52 had more than 3 type colonies indicating contamination and 22 had budding yeast colonies, thus excluded from the study. No growth was found in 551 samples (78.05%). The prevalence of ASB was 21.95%. The most common organism isolated was ESBL-ve E coli (32.25%), followed by ESBL +ve E coli (21.29%) and Enterococcus (15.48%) respectively. E coli were mostly sensitive to nitrofurantoin, amikacin and cotrimoxazole whereas enteroccocus was sensitive to vancomycin. Conclusions: ASB is more common during pregnancy even in first antenatal checkup. We suggest routine urine culture and sensitivity during first antenatal checkup to detect ASB and treat with proper antibiotic to prevent the complications and development of resistance.
Urinary Tract Infection as a Risk Factor for Preterm Delivery: A Tertiary Hospital-Based Study
Indonesian Journal of Obstetrics and Gynecology, 2019
Background: Preterm delivery is the leading cause of perinatal morbidity and mortality in developing countries. Urinary tract infection is one of the infectious diseases that often occur in pregnant women. Despite, the correlation between bacteriuria, either symptomatic or asymptomatic, and preterm delivery is still controversial. Purpose: To investigate the correlation between the incidence of UTI and preterm delivery. Methods: We conducted a cohort retrospective research using patients medical records. We analyzed the incidence of UTI and preterm delivery from January to December 2015, in Dr. Sardjito Hospital, Yogyakarta. Results: The sample of this study covers medical records of 45 patients with preterm delivery. From total sampel, only 25 patients (55.6%) underwent urinalysis. Of these 25 patients, 15 (60%) had UTIs and all of them had preterm delivery. The result showed 13 (86.7%) of 15 patients with bacteriuria were asymptomatic. Bacteriuria that was found in 15 subjects wa...