Asymptomatic bacteriuria in antenatal cases and its effects on obstetrical outcome
Keywords:Asymptomatic bacteriuria, Obstetrical outcome, Urine culture and sensitivity
Background: Urinary tract infection is the second most common bacterial infection seen during pregnancy and is due to the morphological and physiological changes that take place in the genitourinary tract. The pregnant women are two times more commonly affected than age matched non pregnant females and it may lead to less favorable pregnancy outcomes and complications such as premature birth, low birth weight, pyelonephritis, preeclampsia and anemia.
Methods: This hospital based cross sectional study was conducted on 350 pregnant women, falling into the inclusion criteria of the study, who attended the antenatal clinic in the Department of Obstetrics and Gynecology at PCMS and RC, Bhopal, irrespective of the gestational age of the cases. The cases found to have asymptomatic bacteriuria were followed till delivery and any adverse antenatal or perinatal outcome was noted.
Results: The study was conducted with the aim to know the prevalence of asymptomatic bacteriuria and the obstetrical outcome in pregnant women. The prevalence of asymptomatic bacteriuria was 13% and it was common in the age group of 21-25 years, in primigravidas and with period of gestation less than 12 weeks. E. coli was found to be the commonest causative organism. Asymptomatic bacteriuria was found significantly associated with the presence of anemia. Maternal morbidity in terms of pre term labour was higher in cases with asymptomatic bacteriuria.
Conclusions: Urine culture and sensitivity should be done as a routine investigation to screen the patients for asymptomatic bacteriuria and to prevent adverse maternal and fetal outcomes.
Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med. 1993;329:1328-34.
Sampson JE, Gravett MG, Other infectious conditions in pregnancy. In: James DK, Steer PJ, Weiner CP, Govik B, eds. High Risk pregnancy, management options. 2nd ed. London: WB Saunders; 1999:559-598.
Nath G, Chaudhary M, Prakash J, Pandey LK, Singh TB, Jai P. Urinary tract infection during pregnancy and fetal outcome. Indian J Med Microbiol. 1996;14:158-60.
Chandel LR, Kanga A, Thakur K, Mokta KK, Sood A, Chauhan S. Prevalence of Pregnancy Associated Bacteriuria: A study done in a tertiary care Hospital. J Obstet Gynecol India. 2012;62:511-4.
Hankins GD, Whalley PJ. Acute urinary tract infections in pregnancy. Clin Obstet Gynaecol. 1985;28:266-78.
Khatun AK, Rashid H, Chowdhury TA. Prevalence of urinary tract infection in pregnancy. J Bangladesh Coll Phys Surg. 1985;2:6-10.
Nicolle LE. Asymptomatic bacteriuria: when to screen and when to treat. Infect Dis Clin North Am. 2203;17:367-94.
Stenqvist K, Dahlén-Nilsson I, Lidin-Janson G, Lincoln K, Odén A, Rignell S, et al. Bacteriuria in pregnancy. Frequency and risk of acquisition. Am J Epidemiol. 1989;129:372-9.
Girishbabu RJ, Srikrishna R, Ramesh ST. Asymptomatic bacteriuria in pregnancy. Int J Biol Med Res. 2011;2:740-2.
US Preventive Services Task Force. Screening for asymptomatic bacteriuria. In: Guide to clinical preventive services. 2nd ed; 1996.
Gayathree I, Shetty S, Deshpande SR, Venkatesh DT. Screening for asymptomatic bacteriuria in pregnancy. An evaluation of various screening tests in Hassan District Hospital, India. JCDR. 2010;4:2702-6.
Patterson TF, Andriole VT. Bacteriuria in pregnancy. Infect Dis Clin North Am. 1987;1:807-22.
Cowan and Steels manual for the identification of medical bacteria. In: Barrow GI, Feltham RKA, eds. 3rd ed. Cambridge: Cambridge University Press; 1993.
Rubenstein JN, Schaeffer AJ. Managing complicated urinary tract infections: The urologic view. Infect Dis Clin North Am. 2003;17:333-51.
Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection Infect Dis Clin North Am. 1997;11:551-82.
Chukwu OS, Ezeonu IM, Victor MA, Moses NA, Uchenna UG, Owolabi JO, et al. Incidence, aetiology and antibiotic susceptibility profile of asymptomatic bacteriuria in pregnant women in Nsukka Urban, Enugu State, Nigeria. World J Life Sci Med Res. 2014;3(3):94.
Kasinathan A, Thirumal P. Prevalence of asymptomatic bacteriuria in antenatal women attending a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2014;3:437-41.
Lallar M, Haq A, Nandal R. Asymptomatic bacteriuria: predisposing factors and correlation with preterm labor in low resource settings. Int J Reprod Contracept Obstet Gynecol. 2014;3:403-8.
Kerure SB, Surpur R, Sagarad SS, Hegadi S. Asymptomatic bacteriuria among pregnant women. Int J Reprod Contracept Obstet Gynecol. 2013;2:213-6.
Tadesse E, Teshome M, Merid Y, Kibret B, Shimelis T. Asymptomatic urinary tract infection among pregnant women attending the antenatal clinic of Hawassa Referral Hospital, Southern Ethiopia. BMC Research Notes. 2014;7:155.
Ansari HQ, Rajkumari A. Prevalence of asymptomatic bacteriuria and associated risk factors among antenatal patients attending a tertiary care hospital. J Med All Sci. 2011;1(2):74-8.
Vaishali J, Anjoo A, Vinita D. Asymptomatic bacteriuria during pregnancy-health professional’s perspective. J Obstet Gynecol India. 2009;59(5):440-3.
Asopa J, Dadhich Y, Mathur SA. Prevalence of asymptomatic bacteriuria among antenatal women and identification of bacteria in urine. Int J Renal Dis. 2016;1(1):01-5.