UTI in pregnancy

Date Published: 
Tuesday, December 10, 2019
Duration: 
10:45

Dr Bronwyn Sinclair talks about urinary tract infection (UTI) in pregnancy. Bronwyn is an obstetric physician at Waitemata DHB and National Women’s Hospital in Auckland.  She has an interest in the delivery of high end medical care for both general and obstetric patients at the front end of the hospital and works as an Acute Care (General) Physician at North Shore Hospital.

 

Topics:

  • Why is UTI more common in pregnancy?
  • When should we test a pregnant woman’s urine?
  • What constitutes a significant result? A UTI?
  • When selecting an antibiotic what do we need to consider?
  • Asymptomatic bacteriuria - why do we need to worry?
  • The significance of Group B streptococcus
  • Uncomplicated cystitis- what symptoms do woman present with and management?
  • Pyelonephritis – clinical significance, symptoms and presentation on clinical examination.
  • Should we ever treat women with Pyelonephritis in the community?
  • Post discharge follow up of pyelonephritis
  • Are there any other measures a woman can do to prevent UTI?

   

Take home messages

  • All pregnant woman should have a midstream urine culture and sensitivity test at booking.
  • Communication of UTI treatment and results should be communicated with the woman’s lead maternity carer.
  • Group B Streptococcus needs prophylactic antibiotics in labour.
  • Selection of antibiotic depends on gestation, local sensitivities and tissue penetration. Duration depends on indication and clinical response.
  • A follow up midstream urine should always been done post treatment of UTI 7/7 post-treatment and every four weeks for remainder of pregnancy.
  • Suspected pyelonephritis requires hospital admission.

 

Resources

Presenter

Dr Bronwyn Sinclair
Obstetric Physician

 

 

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