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PARTICULAR ASPECTS OF URINARY TRACT INFECTIONS DURING PREGNANCY
Abstract
Background: Renal disorders during pregnancy are variable, ranging from asymptomatic bacteriuria to end stage renal disease. Pregnancy increases the risk of urinary tract infections (UTIs), especially due to the hormonal and mechanical changes, that are predisposing to renal and urinary stasis. UTIs in pregnancy are associated with high risks, both to the fetus and the mother, so adequate management is required. Aim of study was to monitor the incidence and prevalence of lower and upper UTI during pregnancy, as well as complications and evolution under therapy. Material and methods: Our study used a descriptive and prospective plan for the examination of pregnant women diagnosed with urinary tract infection. A total number of 130 patients were followed for 1 year, usually by hospitalization in the Obstetrics and Gynecology Clinic, with nephrological monitoring. Results: From the total number of 130 patients, 82 (63.1%) had at least one urinary infection episode during pregnancy. The most common germ involved in urinary infection at pregnant women was Escherichia Coli (42.7%), followed by Klebsiella (17,1%) and Enterococcus (12.1%). Our study found a high sensibility to cephalosporins, ampicillin, nitrofurantoin and fosfomycin, antibiotics that can be prescribed in pregnant women (according to the 2014 FDA criteria). There was also a significant percentage of unidentified germs (17,1%), often on the background of antibiotic therapy initiation before urinary cultures. Mortality in the study group was 4,8% (4 cases) and occurred in the following patients: 2 cases with toxic-septic shock, 1 case due to intravascular disseminated coagulation secondary to fetal death, 1 case with hemorrhagic shock. Conclusions: Significant bacteriuria in pregnancy is common and represents a serious cause of maternal and perinatal morbidity and mortality. The most common causative agent of urinary tract infection in pregnant women was Escherichia Coli, and the most frequent used antibiotics were ampicillin and cephalosporins.
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