Prevalence of Urinary Tract Infection in Pregnancies with Premature Uterine Contractions

Abstract

Objective: This study aimed to determine the prevalence of urinary tract infection (UTI) among pregnant women with premature uterine contractions. Roles of the current practice of routine simultaneous urinalysis and urine culture in these cases were also evaluated. Materials and Methods: Medical records of pregnant women admitted with premature uterine contractions at Siriraj Hospital between January 2013 and December 2017 were reviewed. Prevalence of UTI in these women was determined. Women were divided into 2 groups based on diagnosis at admission; group 1 included preterm labor/preterm prelabor rupture of membranes (PTL/PPROM), and group 2 was threatened preterm labor (TPL). Evaluations of urinalysis and/or urine culture were performed in these two groups to establish a strategy to reduce unnecessary urine culture. Results: The prevalence of UTI among 2,286 women with premature uterine contractions was 4.9%. Prevalence of UTI were not different between the two groups of women. A positive urine culture was found in 2.4%. The most common organism identified in both groups of women was Escherichia coli. Urinalysis with abnormal cell counts and/or significant presence of bacteria could be used to screen for women in TPL group who should have urine culture with a positive screening rate of 6.5% and 90.9% sensitivity. With this strategy, unnecessary urine culture could be reduced. Conclusion: The prevalence of UTI among pregnant women admitted with premature uterine contractions was 4.9% and was not different between PTL/PPROM group and TPL group. Urinalysis with abnormal cell counts or significant bacteriuria could be a screening tool to reduce number of urine culture in women with TPL.

Keywords

• Asymptomatic bacteriuria
• urinalysis
• urine culture
• premature uterine contractions
• pregnancy outcomes