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Urinary tract infection in pregnancy.
1University Department of Obstetrics and Gynaecology, The Royal Free Hospital School of Medicine, Pond Street, London NW3 2QG, UK. fcunnington@rfc.ucl.ac.uk
International Journal of Antimicrobial Agents
|April 11, 2001
Summary
Screening pregnant women for asymptomatic bacteriuria is routine, but its value needs re-evaluation. Current data suggests higher prevalence and complications than previously reported, necessitating a review of screening methods and treatment efficacy.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Urinary tract infections (UTIs) are common complications during pregnancy.
- Edward Kass's research linked asymptomatic bacteriuria in pregnant women to increased prematurity and perinatal mortality.
- Current screening practices for bacteriuria in pregnancy are standard, but evolving data warrants re-evaluation.
Purpose of the Study:
- To critically review the significance, methods, and costs associated with screening for bacteriuria in pregnancy.
- To re-evaluate the established link between asymptomatic bacteriuria and adverse pregnancy outcomes.
- To analyze current treatment strategies for UTIs in pregnant individuals.
Main Methods:
- Literature review of studies on bacteriuria in pregnancy from 1962 to the late 1990s.
- Comparative analysis of prevalence and complication rates across different time periods and populations.
- Critical assessment of screening methodologies, diagnostic significance, and cost-effectiveness.
- Review of existing treatment protocols for UTIs during gestation.
Main Results:
- The prevalence of asymptomatic bacteriuria and associated complications appears higher in recent data compared to Kass's initial findings.
- Vaginal colonization is increasingly recognized as a significant factor contributing to preterm labor.
- Existing screening protocols and treatment guidelines require reassessment in light of updated epidemiological data.
Conclusions:
- The routine screening for asymptomatic bacteriuria in pregnancy requires re-evaluation due to changing prevalence and complication rates.
- A comprehensive review of screening methods, diagnostic significance, cost-effectiveness, and treatment efficacy is essential.
- Further research is needed to understand the evolving role of bacteriuria and other factors like vaginal colonization in adverse pregnancy outcomes.