Occurrence of urinary tract infection and asymptomatic bacteriuria during pregnancy and its association with maternal outcome

Abstract

: The pregnancy increases the possibility of the case progressing from asymptomatic bacteriuria (ABU) to urinary tract infection (UTI) with symptoms, which may further lead to pyelonephritis and obstetric outcomes. The adverse outcome may result in premature delivery, low weight at birth, and increased foetal mortality. The present study was proposed to assess the occurrence of Symptomatic UTI and asymptomatic bacteriuria, the microorganisms causing UTI in pregnancy, to assess the socio-demographic characteristics involving the risk factors of UTI and the maternal outcome. A total of 152 pregnant women with and without symptoms of urinary tract infection were included as a study subject from January 2011 to April 2011. Midstream urine samples were collected and processed following standard bacteriological tests. In the present study 85 (55.9%) cases were symptomatic UTI and 67 (44.1%) cases were having asymptomatic bacteriuria. was the predominant organism isolated in 61 (49.6%) cases followed by in 24 (19.5%) cases, in 16 (13.0%) cases, CONS 12 (9.7%) cases and in 10 (8.1%) cases. The lower socio-economic status has contributed in 65 (42.8%) cases and the education status of the most of the cases was either high school (47.4%) or primary school (38.8%). Out of 118 cases of vaginal delivery, 101 (85.6%) cases had full term normal delivery, but among 17(14.4%) preterm delivery, 12 (10.2%) were having symptomatic UTI and 05 (4.2%) cases were having asymptomatic bacteriuria.. Our study findings showed that low socioeconomic status and education background were predominant factors associated with increased symptomatic UTI and ABU. There was no significant difference in the prevalence of UTI and ABU with respect to gestational age. It was concluded in the study that the prompt treatment of ABU early in pregnancy significantly reduces the chances of adverse pregnancy outcome. Thus, screening for ABU should ideally be done in the pre-conceptional period. It was also found in our study that higher incidence of UTI was found in third trimester. Hence all pregnant women should be checked for the presence of ABU in the 1st trimester, treated aggressively with suitable antibiotics and promptly followed up.