URINARY TRACT INFECTIONS IN

PREGNANCY
• CONTENTS
• Definition
• Risk factors
• Epidemiology
• Aetiology
• Classification
• Signs and symptoms
• Complications
• Differential diagnoses
• Investigation
• Management
• Prognosis
 DEFINITION
• The presence of atleast 100,000 organisms
per milliliter of urine in an asymptomatic
patient or as more than 100 organism per
milliliter of urine with accompanying
pyuria(>7WBCs/ml) in a symptomatic pt.
 Aetiology
• It can either be an ascending infection or
hematogenous route.
• Examples of common organisms;
E.coli,toxoplasmosis
gondi,syphilis,gonorrhoea,group B streptococcus.
• LOWER UTI (i.e cystitis)
• Upper UTI (i.e pyelonephritis)
• Prevalence ; 3-8%
 RISK FACTORS
• Hormonal and mechanical changes increase
the risk of urinary stasis and vesicoureteral
reflux.
• Short urethra
• Difficulty with hygiene due to distended
pregnant belly.
• As the uterus grows it presses on the and can
prevent emptying.
 SIGNS AND SYMPTOMS
• Dysuria
• Lower abdominal pain
• pyuria
• Frequency
• Urgency
• Nocturia
• Hematuria
• Incotinence
• Fever
• Back Pain
• Nausea and vomiting
 Differential diagnosis
• Bladder cancer
• Bladder stones
• Candidiasis
• Ectopic pregnancy
• Ureteral trauma
• Urethral trauma
• Urethritis
• Group B streptococi colonisation
 complications
• Low birth weight
• Preterm delivery
• hypertension
 investigations
• Urinalysis
• Urine culture
 management
• Good hygiene to reduce bacterial
contamination of the urethral meatus
• Hydration of the pregnant woman
• Antibiotics (amoxillin 3g or cephalexin 2g as a
single dose)
• antipyretics
followup