Urinary tract infections during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Urology

Background:

• Urinary tract infections (UTIs) are the most frequent bacterial infections encountered during pregnancy.
• These infections involve the presence of significant bacteriuria throughout the urinary tract.

Purpose of the Study:

• To conduct a thorough review of urinary tract infections (UTIs) in pregnant individuals.
• To cover all facets of UTIs, including epidemiology, pathogenesis, antimicrobial resistance, clinical presentation, diagnosis, treatment strategies, and preventive measures.

Main Methods:

• Searches of MEDLINE (1966-August 2003) and the Cochrane Library were conducted.
• Keywords included "urinary tract infection," "pyelonephritis," "cystitis," "asymptomatic bacteriuria," and "resistance."
• Articles were selected based on relevance to pregnancy, with a focus on review articles due to limited original clinical studies.

Main Results:

• Pyelonephritis, the most common severe UTI, can lead to adverse perinatal and maternal outcomes such as preterm delivery, low birth weight, fetal mortality, preeclampsia, and anemia.
• Enterobacteriaceae are responsible for 90% of UTIs.
• Commonly used antibiotics include nitrofurantoin, cefazolin, cephalexin, ceftriaxone, and gentamicin.

Conclusions:

• Effective management of UTIs in pregnancy necessitates accurate diagnostic evaluation.
• A deep understanding of antimicrobial agents is vital for optimizing maternal health outcomes.
• Ensuring fetal safety and preventing severe morbidity and mortality in both mother and fetus are paramount.