Asymptomatic bacteriuria in South Indian pregnant women and treatment effect on outcome of pregnancy

Abstract

Asymptomatic bacteriuria is defined as bacteriuria where colony count of same species is more than 10 colonies/ml of urine in a clean catch midstream urine sample in an asymptomatic women”. This if left untreated in pregnancy, may progress to pyelonephritis. Due to the physiological and anatomical changes in the genitourinary tract during pregnancy, urinary tract infection is more common in pregnant women. Our aim was to study the effect of asymptomatic bacteriuria on pregnancy outcome and to find the most common organism responsible for asymptomatic bacteriuria in pregnant women.This was a prospective observational hospital based study conducted in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital. A total of 85 pregnant women were included in the study. Clean catch mid stream urine sample was collected and cultured. The organism was identified and patient was treated according to the antibiotic sensitivity pattern. Patient was followed up till delivery to look for maternal and fetal outcomes.In our study, the prevalence of ASB in pregnancy was 24.7%. 61.9% were in age group of 18-25 years and 42.9% were 2 gravida. 85.7% were in 3rd trimester. Of the ASB cases 90.5% had term babies and 85.7% had babies with birth weight of >2.5 Kg. It is important to do Urine culture and sensitivity in all pregnant women irrespective of the symptoms and gestational age so as to detect ASB as early as possible and by treating this we can avoid the adverse effects in the mother and the fetus.

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis

“…Similar findings have also been observed in Basumatary et al [ 15 ] and Neelima et al [ 16 ], where 61.9% fell within the age bracket of 18-25 years, and 42.9% were experiencing their second pregnancy (gravida 2). Furthermore, 85.7% of cases were identified during the third trimester of pregnancy.…”

A Clinico-microbiological Study of Urinary Tract Infections in Pregnant Women attending Antenatal Clinic of a Tertiary-level Hospital with special reference to Antimicrobial Sensitivity Pattern

“…We observed a prevalence of UTI in pregnant women of 30.35% (Table 2),which was comparable with the prevalence rates reported in studies in Bangladesh (30%) and Egypt (31.3%) [17,18] .The higher prevalence of asymptomatic bacteriuria in our study was alarming since asymptomatic bacteriuria might not be detected early due to lack of symptoms and may rapidly progress to acute pyelonephritis causing significant morbidity for mother and fetus [9].The high prevalence of UTI in general and asymptomatic bacteriuria in particular in pregnant population as observed in our study lead us to suggest that compulsory screening for UTI in pregnancy be continued in the current study setting and be started in other health centers in India and across the developing World. In our study, 42.62% of pregnant women diagnosed with UTI belonged to the age-group of 20 -25 years followed by 26.23% who were of the age group of 26 -30 years, which together amounted to 68.85% of total cases of UTI (Table 4).…”

“…The observed trend in our study thus shows that prevalence of UTI increases with increase in gestational age like Kant et al and Sibi G et al in . The enlarging uterus in later trimesters exerts more pressure on the urinary bladder causing increase in the intravesicular pressure and consequent vesico-ureteric reflux culminating in retention of urine which acts as a suitable environment for bacterial growth [9]. We suggest that screening for bacteriuria be done in the first antenatal visit, regardless of gestational age.…”