Maternal Infection

Question 1

How do you manage UTI in pregnancy?

Answer 1

Analgesia, fluids

MSU for MC+S before Abx given

1st line:
Nitrofurantoin 100mg BD for 7days

If no improvement within 48hrs or when 1st choice not suitable:
Cefalexin 500mg BD 7 days
Also ?presence of pyelonephritis or sepsis

Question 2

What are complications of UTI in pregnancy?

Answer 2

Progression to pyelonephritis +/- urosepsis

Low birth weight, premature delivery

Asymptomatic bacteriuria needs to be screened for at all routine antenatal appointments as has up to 10% prevalence and can progress to severe complications

Question 3

How do you treat maternal group B strep?

Answer 3

GBS is a normal vaginal commensal in many women - if discovered during the antenatal period does not need treatment immediately

Treat with benzylpenicillin IV intrapartum

Alternatively clindamycin

Not routinely screened for, only women with previous GBS should be swabbed - 35-37wks - and if positive, given Abx

Also give to women with pyrexia >38 during delivery and offered to women at risk of preterm regardless of previous GBS

Question 4

What is the risk with untreated GBS?

Answer 4

Most severe and frequent cause of newborn infection