Urinary tract infections

Abstract

Urinary tract infections (UTI) in pregnancy, usually diagnosed based on findings of bacteriuria =105 colony-forming units per mL of urine, are a risk factor for maternal and fetal adverse outcomes. They are usually classified as either symptomatic or asymptomatic. Asymptomatic bacteriuria (ASB) is defined as the presence of significant bacterial growth in urine culture in the absence of UTI symptoms. Cystitis represents bladder involvement and is typically accompanied by dysuria, urgency, and frequent urination. Pyelonephritis, the upper urinary tract infection, is usually accompanied by typical clinical manifestations such as fever, flank pain, sensitivity in the costovertebral angle, nausea, and vomiting. In pregnancy, ASB is associated with an increased risk of pyelonephritis, which may cause severe morbidity for mother and fetus. The primary maternal complications are septic shock syndrome, disseminated intravascular coagulation, renal failure, and acute respiratory distress syndrome. Obstetric adverse outcomes include preterm delivery and low birth weight.