Asymptomatic bacteruria in pregnancy (Complete)

Question 1

When is urine dipstick performed in pregnancy?

Answer 1

Booking visit (8-12 weeks)

16 weeks

28 weeks

34 weeks

36 weeks

38 weeks

41 weeks

Question 2

What aditional weeks urine dipsticks performed if patient is primip?

Answer 2

25 weeks

31 weeks

40 weeks

Question 3

What is the most common cause of bacteriuria

Answer 3

E.coli

Question 4

Why is management required for asymptomatic bacteriuria?

Answer 4

Pregnant woman are at increased risk of ascending infection and foetal complications

Question 5

What maternal complications are associated with UTI in pregnancy?

Answer 5

Pyelonephritis

Hypertension and Pre-eclampsia

Post-partum infection

• C-section scar infections
• Post-partum UTIs

Question 6

What foetal complications are associated with UTI in pregnancy?

Answer 6

Pre-term birth

Low birth weight

Foetal distress and stillbirth

Question 7

What investigations must be conducted in patients with positive dipstck findings?

Answer 7

Bedside:

Microscopy and culture

Abdominal exam: Check for tenderness

Bloods:

FBC

CRP

U&Es: Check renal function

Question 8

How should patients with symptomatic bacteruria be managed in GP setting?

Answer 8

Urgent hospital admission

Question 9

What is the management plan for asymptomatic bacteriuria in pregnancy?

Answer 9

First/2nd-trimester (Up to week 27):

First-line: Nitrofurantoin (100mg BD for 7 days)

Second-line: Cephalexin (500mg BD 7 days) or Amoxicillin

Third-trimester (Week 28):

FIrst-line: Cephalexin or Amoxicillin

Question 10

Nitrofurantoin is contraindicted in which pregnant woman?

Answer 10

Women in third trimester of pregnancy

N.B. Theoretical risk of haemolytic anaemia in the newborn

Question 11

Which antibiotic is preferred for women with UTI in third trimester of pregnancy?

Answer 11

Cephalexin