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Investigation Of Uti In Pregnancy
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UTI is defined as the presence of at least 100,000 organisms per
milliliter of urine in an asymptomatic patient, or as more than 100
organisms/mL of urine with accompanying pyuria (>5 WBCs/mL) in a
symptomatic patient. Particularly in asymptomatic patients, a diagnosis
of UTI should be supported by a positive culture for auropathogen(Emilie
et al., 2011). Untreated asymptomatic bacteriuria is a risk factor for
acute cystitis (40%) and pyelonephritis (25-30%) in pregnancy. These
cases account for 70% of all cases of symptomatic UTI among unscreened
pregnant women (Emilie et al., 2011). Symptomatic and asymptomatic
bacteriuria have been reported among 17.9% and 13.0% pregnant women,
respectively (Masinde et al., 2009).
Pregnancy increases the risk of
UTI. At around 6th week of pregnancy, due to the physiological changes
of pregnancy the ureters begin to dilate. This is also known as
“hydronephrosis of pregnancyâ€, which peaks at 22-26 weeks and continues
to persist until delivery. Both progesterone and estrogens levels
increase during pregnancy and these will lead to decreased ureteral and
bladder tone. Increased plasma volume during pregnancy leads to decrease
urine concentration and increased bladder volume. The combination of
all these factors lead to urinary stasis and uretero-vesical reflux
(Delzell and Lefevre, 2000).Additionally, theapparent reduction in
immunity of pregnant women appears toencourage the growth of both
commensal and non-commensalmicroorganisms (Scott et al., 1999). The
physiological increase in plasmavolume during pregnancy decreases urine
concentration and upto 70% pregnant women develop glucosurea,
whichencourages bacterial growth in the urine (Patterson and Andrriole,
1987; Lucas and Cunningham, 1993).
Female gender itself is a risk
factor because of short urethra, its proximity to vagina and anus and
inability of women to empty their bladder completely. High incidence is
seen in lower socioeconomic group (Wesley, 2002). Sexual activity and
certain contraceptive methods are also said to increase the risk
(Bandyopadhyay et al., 2005) The anatomical relationship of female’s
urethra and the vagina makes it liable to trauma during sexual
intercourse as well as bacteria been massaged up the urethra into the
bladder during pregnancy/child birth (Arthur et al., 1975; Duerden et
al., 1990). Abnormalities of urinary tract or stones, diabetes mellitus,
immunosupression and past history of UTI tend to increase the risk
(Patterson and Andriole, 1997).
Urinary tract infection during
pregnancy contributes significantly to maternal and perinatal morbidity
(Akerele et al., 2002). Abortion, small birth size, maternal anemia,
hypertension, preterm labour, phlebitis, thrombosis and chronic
pyelonephritis are related to urinary tract infection during pregnancy
(Akerele et al., 2002; Onuh et al., 2006).
coli remains the
predominant organism implicated in urinary tract infection in pregnancy,
though recent reports show changes in pattern of the infection (Onuh et
al., 2006). Recent studies in Nigeria show an increasing involvement of
Klebsiella Spp. Staphylococcus aureus, Proteus spp., and Pseudomonas
spp. in urinary tract infection in pregnancy (Abdul andOnile, 2001).
Studies
have also shown that treatment of bacteriuria during pregnancy reduces
the incidence of these complications (Patterson and Andriole, 1987) and
lowers the long-term risk of sequelae following asymptomatic bacteriuria
(Barr et al., 1985).
1.2 OBJECTIVES OF THE RESEARCH
This objectives of this research are to;
Investigate the Urinary tract infections in pregnancy
Investigate Urinary tract infections in relation to age distributions of pregnant women.
Determine percentage of occurrence and distribution of bacterial pathogens in Urinary tract infections among pregnant women
1.3 JUSTIFICATION
Urinary
tract infections typically occur when bacteria enter the urinary tract
through the urethra and begin to multiply in the bladder. Although the
urinary system is designed to keep out such microscopic invaders, these
defenses sometimes fail. When that happens, bacteria may take hold and
grow into a full-blown infection in the urinary tract. Antibiotic
sensitivity can be tested with urine culture, making it useful in the
selection of antibiotic treatment.
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ABSRACT - [ Total Page(s): 1 ]This study investigates the bacteriological aetiology and Urinary Tract Infections (UTIs) among pregnant women attending antenatal clinics at hospitals in Enugu metropolis.70 mid-stream urine samples were collected and cultured for the presence of bacterial pathogens, 38 of which showed significant bacterial growth while the remaining 32 showed no significant bacterial growth.Bacterial agents were isolated from 38 pregnant women and were identified as: Escherichia coli; Klebsiellaspp., Proteus m ... Continue reading---
