Pregnant women are at higher risk of developing lower urinary tract infections and pyelonephritis
Urinary tract infections in pregnant women increase the risk of preterm delivery
They may also increase the risk of other adverse pregnancy outcomes, such as low birth weight and pre-eclampsia
Asymptomatic bacteriuria
Refers to bacteria present in the urine, without symptoms of infection
Pregnant women are tested for asymptomatic bacteriuria at booking and routinely throughout pregnancy
Testing for bacteria in the urine of asymptomatic patients is not recommended as it may lead to unnecessary antibiotics; Pregnant women are an exception to this rule, due to the adverse outcomes associated with infection
Management
Antibiotics for UTI or asymptomatic bacteriuria during pregnancy
First line:
1st or 2nd trimester nitrofurantoin MR 100mg bd or 50mg qds
3rd trimester trimethoprim 200mg bd
2nd line (any trimester) cefalexin 500mg tds or as per sensitivities
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