Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems.
Arch Med Sci. 2015 Mar 16;11(1):67-77.
Matuszkiewicz-Rowińska J1, Małyszko J2, Wieliczko M1.
1Chair and Clinic of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
2Department of Nephrology and Transplantation, Medical University of Bialystok, Bialystok, Poland.
Urinary tract infections (UTIs) are common in pregnant women and pose a great therapeutic challenge, since the risk of serious complications in both the mother and her child is high.
Pregnancy is a state associated with physiological, structural and functional urinary tract changes which promote ascending infections from the urethra.
Unlike the general population, all pregnant women should be screened for bacteriuria with urine culture, and asymptomatic bacteriuria must be treated in every case that is diagnosed, as it is an important risk factor for pyelonephritis in this population. The antibiotic chosen should have a good maternal and fetal safety profile.
In this paper, current principles of diagnosis and management of UTI in pregnancy are reviewed, and the main problems and controversies are identified and discussed.