Urinary Tract Infection in Pregnancy

Question 1

Risk of UTI in pregnancy

Answer 1

Increases the risk of preterm delivery

Question 2

Asymptomatic Bacteriuria

Answer 2

Refers to bacteria present in the urine, without symptoms of infection

Question 3

Risk of asymptomatic bacteriuria in pregnant women

Answer 3

Higher risk of developing lower urinary tract infections and pyelonephritis

Therefore at risk of preterm birth

Question 4

When are pregnant ladies tested for asymptomatic bacteriuria

Answer 4

Booking and routinely throughout pregnancy

Question 5

Presentation of a lower UTI

Answer 5

Dysuria (pain, stinging or burning when passing urine)

Suprapubic pain or discomfort

Increased frequency of urination

Urgency

Incontinence

Haematuria

Question 6

How does pyelonephritis present

Answer 6

Fever

Loin, suprapubic or back pain

Looking and feeling generally unwell

Vomiting

Loss of appetite

Haematuria

Renal angle tenderness on examination

Question 7

Urine Dipstick results

Answer 7

Nitrites - more specific for a bacterial infection

Leukocytes

Question 8

Common causative organism for UTIs

Answer 8

Escherichia coil

Question 9

Management of a UTI in pregnant women

Answer 9

7 days of antibiotics:

• Nitrofurantoin (avoid in the third trimester)
• Amoxicillin (only after sensitivities are known)
• Cefalexin

Question 10

Risk of nitrofurantoin in the third trimester

Answer 10

Neonatal haemolysis

Question 11

Risk of trimethoprim in the first trimester

Answer 11

Can cause congenital malformations, particularly neural tube defects (i.e. spina bifida)