Urinary Tract Infections in Pregnant Women in Second Trimester and the Risk of Preterm Birth
Journal
BANTAO Journal
Date Issued
2020-06
Author(s)
Abstract
Introduction. Preterm birth, defined as delivery less than 37 weeks of gestation, is the most common cause of neonatal mortality and morbidity accounting for 11% of pregnancies worldwide. Pregnancy causes nume¬rous changes in the woman’s body that increase the risk of urinary tract infections (UTIs). Hormonal and mechanical changes can promote urinary stasis and ve¬sicoureteral reflux, along with an already short urethra (3-4 cm in females) and difficulty with hygiene due to a distended pregnant belly, help make UTIs the most common bacterial infections during pregnancy predo¬mi¬nantly with Escherichia coli, but also with Staphylococcus saprophyticus, Klebsiella, Enterobacter, Proteus, Entero¬coccus, etc. The aim of the study was to prove the re¬lationship between UTIs in pregnancy and their risk to cause preterm birth (<37 g.w.).
Methods. This is a prospective case- control study, conducted at the University Clinic of Gynaecology and Obstetrics, Ss’ Cyril and Methodius University, Medical Faculty, Skopje, Republic of North Macedonia at the Department of High-Risk pregnancy. The study included 103 patients with signs and symptoms of preterm labour.
Patients between 28-36 g.w. were followed until the end of the pregnancy. Obstetric ultrasound on Voluson 730 pro machine was performed by two experienced ultrasound observers calculating the fetal weight, esti¬mating the gestational week and measuring the cervi¬cal length so the variations for the measurements have been minimized.
Mid-stream urine sample was sent for cytology and culture-sensitivity.
Results. All 103 patients in the study had signs and symptoms of preterm labour. Out of the total of 103 patients 65 (63%) had a positive urine sample, and 38 (36.9%) patients had negative urinalysis. The results showed that patients who had signs and symptoms of preterm birth were significantly different in women who had po¬sitive compared to those who had negative urine sample (p=0.0049). Microorganisms cultured in urine were predominantly gram-negative bacilli, although there were also gram-positive bacilli detected. E coli was the commonest microorganism cultured in the urine.
Conclusion. Urogenital infections contribute signi¬fy-can¬tly to the preventable causes of preterm labor. The be¬nefit of the study lies in detecting asymptomatic ca-ses, so that this complication can be timely prevented. Making early diagnosis of urogenital infections and treating them adequately with the antimicrobials will help in dec¬reasing the incidence of preterm labor, preterm births, and the associated neonatal and maternal morbidities.
Methods. This is a prospective case- control study, conducted at the University Clinic of Gynaecology and Obstetrics, Ss’ Cyril and Methodius University, Medical Faculty, Skopje, Republic of North Macedonia at the Department of High-Risk pregnancy. The study included 103 patients with signs and symptoms of preterm labour.
Patients between 28-36 g.w. were followed until the end of the pregnancy. Obstetric ultrasound on Voluson 730 pro machine was performed by two experienced ultrasound observers calculating the fetal weight, esti¬mating the gestational week and measuring the cervi¬cal length so the variations for the measurements have been minimized.
Mid-stream urine sample was sent for cytology and culture-sensitivity.
Results. All 103 patients in the study had signs and symptoms of preterm labour. Out of the total of 103 patients 65 (63%) had a positive urine sample, and 38 (36.9%) patients had negative urinalysis. The results showed that patients who had signs and symptoms of preterm birth were significantly different in women who had po¬sitive compared to those who had negative urine sample (p=0.0049). Microorganisms cultured in urine were predominantly gram-negative bacilli, although there were also gram-positive bacilli detected. E coli was the commonest microorganism cultured in the urine.
Conclusion. Urogenital infections contribute signi¬fy-can¬tly to the preventable causes of preterm labor. The be¬nefit of the study lies in detecting asymptomatic ca-ses, so that this complication can be timely prevented. Making early diagnosis of urogenital infections and treating them adequately with the antimicrobials will help in dec¬reasing the incidence of preterm labor, preterm births, and the associated neonatal and maternal morbidities.
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