1. URINARY TRACT INFECTION IN PREGNANCY

2. A urinary tract infection (UTI) is an infection that begins in the urinary system.
UTIs limited to the bladder can be painful and annoying.

4. Parts of the urinary tract
two kidneys - a pair of purplish-brown organs located below the ribs toward the middle of the back.
two ureters - narrow tubes that carry urine from the kidneys to the bladder.
bladder - a triangle-shaped, hollow organ located in the lower abdomen.
two sphincter muscles - circular muscles that help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder.
urethra -the tube that allows urine to pass outside the body.

6. Pregnancy and urinary tract infections:
CHANGES IN THE URINARY SYSTEM DURING PREGNANCY
Kidney enlargement
Compression of the ureters and bladder
Incomplete emptying of the bladder
The urine is not as acidic
It contains more sugars, protein, and hormones.

7. Types of UTI in pregnancy
ASYMPTOMATIC BACTERIURIA
silent (without symptoms) infection
caused by bacteria present in the woman's system before pregnancy
may lead to pyelonephritis if left untreated.
ACUTE URETHRITIS OR CYSTITIS
symptoms including pain or burning with urination, frequent urination, feeling of needing to urinate, and fever.
PYELONEPHRITIS
a kidney infection
symptoms of acute cystitis plus flank (back) pain
may lead to preterm labor, severe infection, and adult respiratory distress syndrome.

8. The most common causative organism of UTI
Escherichia coli (E. coli)
Other organisms may also cause UTI
group B streptococcus, and sexually transmitted gonorrhea and chlamydia.

9. Signs and symptoms A strong, persistent urge to urinate
A burning sensation when urinating
Passing frequent, small amounts of urine
Blood in the urine (hematuria) or cloudy, strong-smelling urine

10. Diagnosis: Dip slide technique
Treatment: For 7 to 10 days
Ampillicin 500 mg qid
Nitrofurantoin 100 mg qid
Cephalexin 500 mg tid
Amoxicillin – Clavulanic acid 375 mg tid
In case of recurrent infection, Nitrofurantoin 50mg or Amoxycillin 250mg at night to continue till
delivery

11. Cystitis
Results from bacterial infections of the bladder
Often in the 16th week of pregnancy with marked retroversion of the gravid uterus
Urine examination reveals:RBC,pus cells and bacteria
Treatment:antimicrobial therapy and correction of retoversion.

12. Pyelonephrititis
Condition characterized by an inflammation of the renal parenchyma and collecting tubules
Predisposing factors:
Progesterone
Pressure by the gravid uterus

13. Clinical features
Symptomatic manifestations like fever, malaise, nausea, vomiting and urgency of micturition and tenderness at renal angle of the affected side.
Investigations
Hb, TC and DC, C – reactive protein
Blood culture
Urine:smear,culture and antibiotic sensitivity
Renal function test

14. Management
Admission to hospital
Complete bed rest
Intravenous fliuds
Intravenous antibiotics
Antipyretics
Continuation of treatment with oral antibiotics for at least 2 weeks

15. Complications Septicemia ARDS Renal abscess and scarring
Preterm labour and delivery
Increased perinatal morbidity and mortality
DIC

16. Prevention of UTI Drink plenty of liquids Urinate promptly
Wipe from front to back
Empty your bladder as soon as possible after intercourse. Also, drink a full glass of water to help flush bacteria.
Avoid potentially irritating feminine products