UTI

Question 1

What are the RFs of UTI in pregnancy?

Answer 1

women are at increased risk from week 6 to 24 due to possible blockages

Question 2

What are the Ix of UTI in pregnancy?

Answer 2

o Urinalysis
performed at every antenatal visit
o Urine MC&S
MSU sent at booking visit as a screening test
 Protein (renal disease, preeclampsia)
 Persistent glycosuria (T1/T2DM or GDM)
 Nitrites (UTIs)

Question 3

What are the S/S of UTI in pregnancy?

Answer 3

FUND HIPS:
o Pain or burning, frequency, urgency, blood or mucus in urine, lower abdo pain
o Dyspareunia, foul smelling urine
o Signs of infection

Question 4

What is the Management of UTI in pregnancy?

Answer 4

no visible haematuria -> MC&S (GBS) -> ABx:
 Advice and general care -> analgesia, avoid dehydration
 MSU before ABx starts
 Immediate antibiotic treatment (7 days):
• 1st line:
o Nitrofurantoin (AVOID AT TERM; 100mg, BD, 7 days); OR
• 2nd line:
o Amoxicillin (500mg, TDS, 7 days); OR
o Cephalexin (500mg, BD, 7 days)

Question 5

What is the Mx of asymptomatic bacteruria?

Answer 5

MC&S (GBS) -> ABx:
 Immediate antibiotic treatment (7 days):
• Nitrofurantoin (AVOID AT TERM; 100mg, BD, 7 days); OR
• Amoxicillin (500mg, TDS, 7 days); OR
• Cephalexin (500mg, BD, 7 days)
 If GBS identified, write in notes as IV benpen will be required intrapartum

Question 6

What is the Mx of pyelonephritis?

Answer 6

 Cephalexin; OR

 Cefuroxime

Question 7

What are the complications of UTI in pregnancy?

Answer 7

o Asymptomatic bacteriuria associated with:
 Preterm delivery
 Pyelonephritis during pregnancy -> LBW and early labour
o Good if treated early and well
o Trimethoprim is contraindicated in the first trimester