Urinary Tract Complications in Pregnancy Flashcards
(25 cards)
What is asymptomatic bacteriuria?
Presence of multiplying bacteria in the urinary tract (excluding distal urethra) without symptoms.
What is the incidence of asymptomatic bacteriuria in pregnancy?
2–7%
What are the common risk groups for asymptomatic bacteriuria?
Women with sickle cell trait and diabetes.
What percentage of untreated asymptomatic bacteriuria progresses to pyelonephritis?
25–30%
How is asymptomatic bacteriuria diagnosed?
Colony count >10⁵ organisms/mL in 2 consecutive clean-catch samples.
What is the most common group of organisms in asymptomatic bacteriuria?
Gram-negative organisms.
What is acute pyelonephritis?
Infection of the renal pelvis and kidney, occurring in 1–2% of pregnancies.
What are the maternal symptoms of acute pyelonephritis?
Fever, chills, flank pain, nausea, vomiting, dysuria, frequency, leukocytosis, thrombocytopenia.
What are the foetal complications of acute pyelonephritis?
Prematurity, small-for-gestational age (SGA) babies.
What findings are seen in urine analysis in acute pyelonephritis?
Bacteriuria, pyuria, WBC casts, haematuria.
What is the treatment for acute pyelonephritis?
Hospital admission, IV antibiotics (e.g. nitrofurantoin, cephalosporins), fluids, antipyretics.
What is acute renal failure (ARF)?
Temporary loss of kidney function with urine output <40 ml/day, elevated BUN and creatinine.
What are common causes of ARF in pregnancy?
Hypovolaemia (e.g. haemorrhage), sepsis, abruptio placentae, PET, DIC.
What are the classifications of ARF?
Pre-renal (hypoperfusion), Renal (intrinsic), Post-renal (obstruction).
What are the phases of acute renal failure?
Oliguric phase → Diuretic phase → Recovery phase.
What are clinical signs of the oliguric phase of ARF?
↓ urine output, ↑ urea & potassium, metabolic acidosis.
What are the signs of the diuretic phase?
Large volumes of dilute urine, electrolyte loss.
What are the complications of ARF?
Cardiac arrhythmias, thrombocytopenia, infections, electrolyte imbalances (hyperK+, hypoNa+, hyperMg2+, hypoCa2+).
What are the main causes of death in pregnancy-related ARF?
Infection, azotemia, pulmonary oedema, hyperkalaemia-induced arrhythmia.
How is ARF treated?
Treat cause, surgical correction, fluid/electrolyte balance, insulin-glucose for hyperK+, dialysis.
What are physiological changes in the urinary tract during pregnancy?
Kidney enlargement, ureter/bladder compression, incomplete bladder emptying, urine less acidic, increased sugars/proteins.
What factors contribute to increased UTI risk during pregnancy?
Hormonal changes, intercourse, bladder reflux, condom/spermicide use, enlarged uterus.
What are the common causative organisms of UTIs in pregnancy?
E. coli, S. aureus, Proteus mirabilis, S. saprophyticus, Streptococcus spp., Citrobacter, Klebsiella, Enterobacter, Pseudomonas.
Which organism is most commonly associated with UTI in pregnancy?
Escherichia coli (50.8%)
