Urinary tract infection among pregnant women and its association with maternal and fetal outcome

Abstract

Background:Urinary tract infections is the most common bacterial infection complicating pregnancies.Antepartum urinary tract infection both symptomatic and asymptomatic has been implicated as risk factor for adverse perinatal and maternal outcomes. Screening and diagnosis of both symptomatic and asymptomatic urinary tract infection and it’s appropriate management is essential to decrease various maternal and fetal complications. Objective 1) To identify the common causative organisms and their antibiotic sensitivity. 2) To assess the maternal and fetal outcome of pregnancy with urinary tract infection Methodology Prospective cross-sectional study was conducted on 1100 pregnant woman attending the OPD and those admitted in the antenatal ward in Department of OBG at ESIC & PGIMSR. All the subjects were informed to collect clean catch midstream urine sample in a wide mouth sterile container. Any sample with > 5 pus cells / Hpfwere considered as significant.The sample was cultured on 5% sheep blood agar and Mac Conkey agar and incubated at 370c ambient air incubator for 18- 24 hours. Women with bacteriuria were treated with 10-14 days course of antimicrobial drugs as per sensitivity of organism.All patients were followed up till delivery and outcomes were documented. Results · Among 1100 pregnant women screened during antenatal period the incidence of urinary tract infection was 12.3%. · 92(68.1%) were asymptomatic and 43 (31.9%) were symptomatic. · UTI in pregnancy was more common in age group of 24-29 years (65.2%) and is more common in multigravida (68.1%). · Common pathogen isolated in urine culture was E coli (52.6%), followed by Klebsiella (28.9%) · Among 135 pregnant women with UTI anemia occurred in 26.7%, premature rupture of the membrane in 9.6%, none of them have pyelonephritis.31.1% of them had low birth weight babies,66.7% of them had pre-term babies and 23.7% had IUGR Babies. · The incidence of anemia and preterm labour among those with UTI was significantly higher compared to incidence among those without UTI with P VALUE <0.001. Conclusion: Screening and diagnosis of both symptomatic and asymptomatic urinary tract infection and it’s appropriate management is essential to decrease various maternal and fetal complications.