UTI in pregnancy

Question 1

Screening for asymptomatic bacteriuria in pregnancy

Answer 1

Pregnant women are tested at booking and routinely throughout pregnancy

Question 2

Presentation of UTI in pregnancy

Answer 2

Dysuria
Suprapubic pain
Increased frequency
Urgency and incontinence
Haematuria
Fever

Question 3

Also important to ask these symptoms

Answer 3

Any loin/back pain, more prominent fever, feeling generally unwell, renal angle tenderness –> PYELONEPHRITIS

Question 4

Investigations in UTI

Answer 4

Urine dipstick - for nitrites or leucocytes

Question 5

Most common cause of UTI

Answer 5

E.Coli

Klebsiella pneumoniae
Enterococcus

Question 6

Management

Answer 6

7 day course of antibiotics

• Nitrofurantoin (avoid in 3rd trimester - risk of neonatal haemolysis)
• Amoxicillin
• Cefalexin

Avoid trimethoprim esp in first trimester - as it is a folate antagonist