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Published on: December 4, 2020
[Urinary tract infection in pregnancy]
Geraldo Duarte1, Alessandra Cristina Marcolin, Silvana Maria Quintana
1Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil. gduarte@fmrp.usp.br
Summary
Urinary tract infections (UTIs) in pregnancy require prompt diagnosis and treatment. Asymptomatic bacteriuria (AB) in pregnant women can lead to pyelonephritis, necessitating effective antibiotic strategies.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Pharmacology
Context:
- Urinary tract infections (UTIs) are a significant concern during pregnancy, impacting both maternal and perinatal health.
- Pregnancy-associated anatomical and physiological changes predispose women with asymptomatic bacteriuria (AB) to symptomatic UTIs.
- Asymptomatic bacteriuria affects 2-10% of pregnant women, with a 30% risk of developing pyelonephritis if untreated.
Purpose:
- To highlight the importance of diagnosing and treating asymptomatic bacteriuria in pregnant women.
- To discuss appropriate microbiological diagnostic criteria and treatment strategies for UTIs during gestation.
- To evaluate antibiotic options for treating pyelonephritis in pregnant patients.
Summary:
- Diagnosis of UTIs relies on microbiological evidence, specifically two urine cultures with >10(5) colonies/mL.
- Treatment should be guided by antibiogram results, with cefuroxime being a preferred option for pyelonephritis due to its efficacy and administration profile.
- Alternative treatments include norfloxacin, while nitrofurantoin is recommended for prophylaxis, avoiding late-term use.
Impact:
- Emphasizes the need for increased awareness and proactive management of UTIs in prenatal care.
- Provides evidence-based recommendations for antibiotic selection and duration in pregnant women with UTIs.
- Aims to improve maternal and perinatal outcomes by optimizing UTI management during pregnancy.
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