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Should asymptomatic bacteriuria be screened in pregnancy?
1Department of Family Medicine, Uludag University, Faculty of Medicine, Gorukle Bursa, Turkey.
Clinical and Experimental Obstetrics & Gynecology
|March 15, 2003
Summary
Asymptomatic bacteriuria affects 9.31% of pregnant women, increasing risks for preterm labor and pyelonephritis. Routine screening and treatment are recommended to prevent these pregnancy complications.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Urology
Background:
- Asymptomatic bacteriuria (ASB) during pregnancy occurs in 2-14% of cases.
- ASB can lead to serious fetal and maternal complications, including acute pyelonephritis, hypertension, anemia, preterm labor, low birth weight, and intrauterine growth retardation.
Purpose of the Study:
- To determine the incidence of ASB in pregnant women.
- To investigate the association between ASB and pregnancy complications.
Main Methods:
- Prospective screening of 270 pregnant women up to 32 weeks gestation using urine culture.
- Retrospective control group of 186 pregnant women not screened for ASB.
- Evaluation of leucocyturia as a screening test for ASB.
Main Results:
- The incidence of ASB was 9.31%, with Escherichia coli being the most common pathogen (79%).
- Leucocyturia showed high sensitivity (91.3%) and negative predictive value (98.5%) but low positive predictive value (45.6%) for ASB.
- Women with ASB had a significantly higher risk of preterm labor (26% vs. 9.3%) and acute pyelonephritis (0.5% in screened vs. 2.1% in unscreened).
Conclusions:
- ASB is prevalent in pregnant women and significantly associated with adverse pregnancy outcomes.
- Routine screening and prompt treatment of ASB in pregnancy are crucial for preventing complications.
- Leucocyturia can be a useful but not definitive screening tool for ASB in pregnancy.