A Case Control study of prevalence of asymptomatic bacteriuria in preterm labour

Abstract

Background & Objectives: Asymptomatic bacteriuria during pregnancy is one of the risk factor for preterm delivery if untreated. The aim of this study is to find out the prevalence of ASB in pregnant women presenting with preterm labour pain and also to determine the common pathogenic micro-organisms associated and their antibiotic sensitivity. Methods: This is a prospective case- control study carried out in the Jubilee Mission Hospital, Thrissur, Kerala from Oct 2013 to March 2015. Cases (50) are those who came with preterm labour and patients in the control (50) group are those who do not present with preterm labour pain between 24-37 weeks. Patients were selected with specific inclusion and exclusion criteria. They were followed till delivery and treatment was given accordingly. Both maternal and fetal outcomes were noted. Results: Asymptomatic bacteriuria was present in 11 patients whoc presented with preterm labour pain and hence the prevalence of asymptomatic bacteriuria in preterm labour in the study population was 22%. Most common pathogenic organism found was E.coli (20%) followed by Klebsiella (2%). Mixed growth suggestive of contamination was found in both case (14%) and control (12%) group. Sensitivity to nitrofurantoin was seen in 4 cultured samples (36.36%) of the patients with ASB. Conclusion: Asymptomatic bacteriuria is a common infection in pregnancy and they are at an increased risk for adverse maternal and fetal outcomes which could be prevented by antimicrobial therapy. Hence pregnant women should be screened for bacteriuria and treated with appropriate antibiotics according to the sensitivity. Keywords: Asymptomatic bacteriuria, UTI, Pregnant women, Preterm labour, E. Coli