UTI in Pregnancy

Question 1

what is the link between UTI and pregnancy?

Answer 1

pregnancy predisposes to UTI

Question 2

true or false: UTIs tend to be more severe in pregnancy

Answer 2

true - pregnant patients have a higher rate of pyelonephritis

Question 3

suggest 3 complications of UTI in pregnancy

Answer 3

UTI predisposes to preterm delivery (? due to physiological stress on the body)

low birth weight

pre-eclampsia

Question 4

Why is asymptomatic bacteriuria treated in pregnant women?

Answer 4

because there is a high risk of this developing into a UTI and UTI is associated with complications in pregnancy

Question 5

how might asymptomatic bacteriuria be detected in pregnancy?

Answer 5

pregnant patients are routinely screened for bacteriuria with MC+S throughout pregnancy

Question 6

differentiating lower UTI from pyelonephritis

Answer 6

pyelonephritis is more likely to present with:

fever

vomiting

loin/back pain

renal angle tenderness on examination

Question 7

what is MC+S

Answer 7

microscopy

culture

sensitivities

Question 8

testing for urinary tract infection: MSU or first pass?

Answer 8

MSU

Question 9

treatment of urinary tract infection in pregnancy - how long?

Answer 9

7/7

Question 10

antibiotic for UTI which is best avoided in the first trimester

Answer 10

trimethoprim (folate antagonist)

NB trimethoprim is not known to be harmful after the first trimester but it is still avoided unless absolutely necessary

Question 11

which antibiotic for UTI is best avoided in the third trimester?

Answer 11

nitrofurantoin - risk of neonatal haemolysis

Question 12

first line antibiotic for UTI in pregnancy

Answer 12

nitrofurantoin

Question 13

second line options for UTI in pregnancy (2)

Answer 13

amoxicillin or cefalexin