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PREGNANT? HOW TO KEEP YOU AND YOUR BABY HEALTHY —GET SCREENED FOR INFECTIONS DURING YOUR PREGNANCY —URINARY TRACT INFECTIONS (UTI)

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Feb 03, 2022 · By Shannon M. Clark
Certain infections can have profound effects during pregnancy. We are going to share with you what screening tests you should expect from your obstetrical care provider, when you should have these tests, and questions to ask. Being informed is your best strategy to having a healthy pregnancy.

Why screen for infections during pregnancy?
Because certain adverse outcomes can be avoided with routine screening for certain infections during pregnancy.

This blog series will provide you with an overview of the recommended screening tests for infectious diseases during your prenatal care. Knowledge of these routine screening tests--when the test is recommended during pregnancy, what specific testing method you should expect, and accurate interpretation of test results-- is part of the basic understanding of your routine prenatal care.

Recommended Routine Screenings for Infectious Diseases During Pregnancy
  • Urinalysis/Urine Culture for a urinary tract infection (UTI): Blog 1
  • Hepatitis B & C: Blog 2
  • Human Immunodeficiency Virus (HIV): Blog 3
  • Rubella and Varicella (Measles and Chicken Pox):  Blog 4
  • Sexually Transmitted Infections (Chlamydia, gonorrhea, and syphilis): Blog 5
  • Group B Strep (GBS): Blog 6
  • Tuberculosis (TB): Blog 7

Understanding Urinalysis/Urine Culture During Your Pregnancy
As with all infectious disease screenings, diagnosis of asymptomatic bacteriuria (symptoms are not present) and a UTI (symptoms are present) in pregnancy is essential because pregnant patients are subject to adverse pregnancy outcomes, i.e. pyelonephritis and urosepsis, if these infections are left undetected and untreated.

When to Screen
Screening may be done at every prenatal visit, only upon entry to care, or at 12-16 weeks of pregnancy, and then reassessed based on your risk factors, medical conditions, or symptoms or  complaints.

Testing Method and How it is Done
A urine sample done during a routine prenatal visit may be assessed in the office via urine dipstick. A urinalysis is collected in the office and sent to the lab for formal analysis.
There are three ways to collect a urine specimen during a routine prenatal care visit:
  1. Midstream, clean-catch specimen after cleansing of the urethral meatus and surrounding tissues spreading the labia
  2. Collecting a specimen midstream
  3. Catherization
While the latter is typically not done, the other two methods are more commonly utilized with a goal of collecting a noncontaminated specimen.

What are They Looking for in Your Sample?
Typically, a urine sample done during a routine prenatal visit is assessed for the presence of blood, protein, glucose, ketones, leukocyte esterase, and nitrates via urine dipstick, with the addition of a pH, specific gravity, and bilirubin if the sample is sent to the laboratory for a formal urinalysis. Both are considered screening tests for a UTI or asymptomatic bacteriuria in pregnancy, whereas the urine culture is diagnostic.

A urine culture for a definitive diagnosis, identification of the offending pathogen (bacteria), and antibiotic sensitivities, should be done if the urine dipstick or urinalysis is suggestive of asymptomatic bacteriuria or urinary tract infection. If the screening is done only on your entry to care or at 12-16 weeks of your pregnancy, a urine culture should be sent to assess for asymptomatic bacteriuria

Some Questions to Ask your Healthcare Provider
  • Why is the risk of complications of a urinary tract infection (UTI) increased during pregnancy?
  • What are the treatment options for a urinary tract infection (UTI) during pregnancy?
  • What are the risks of asymptomatic bacteriuria during pregnancy?
  • How can a urinary tract infection (UTI) potentially affect my fetus?
To learn more about perinatal infections, visit labready.com and reach out to our professionals at hello@labready.com

About the Author:
Shannon M. Clark, MD, MMS, FACOG is a double board-certified Obstetrician and Gynecologist, and Maternal-Fetal Medicine Specialist focusing on the care of pregnant individuals with maternal and/or fetal complications of pregnancy. After finishing medical school at the University of Louisville School of Medicine in Louisville, KY, Dr. Clark completed a residency in Obstetrics and Gynecology at Allegheny General Hospital in Pittsburgh, PA. During her first year of residency, she realized her passion for taking care of individuals with complicated, or high-risk, pregnancies and subsequently pursued a fellowship in Maternal-Fetal Medicine and a master’s degree in Medical Science at the University of Texas Medical Branch in Galveston, TX where she is a Professor with roles as clinician, researcher, and educator.

Next blog in the series:
Pregnant? How to Keep You and Your Baby Healthy
Get Screened for Infections During your Pregnancy -- Hepatitis B & C

References


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