Urinary tract infections in pregnant women

Abstract

Urinary tract infections (UTIs) are the most common pathology among pregnant women and are associated with maternal and foetal complications. According to some authors, the incidence of UTIs increased 4 times in the last decades of the 20th century. Escherichia coli is the most predominant pathogen causing up to 80% of UTIs, Klebsiella is ranked second causing up to 8% of UTIs, and pathogenic staphylococcus and mixed microflora are ranked third. To diagnose UTIs, laboratory, physical and radiological diagnostic methods are applied. According to most authors, informative value yielded by lab tests is more than 90%. The prescription of antibacterial chemotherapy should be based on the results of urine culture and sensitivity testing. Before the test results are obtained, broad-spectrum antibacterial drugs (ABs) are usually prescribed. The most commonly used therapy regimens are third-generation cephalosporins with dose adjustments, as may be necessary, after sensitivity is determined. Some authors recommend to continue treatment with urinary tract antiseptics after AB therapy is completed. The impaired urine output should be restored before AB therapy is prescribed. This review presents an analysis of the literature that was found in the databases PubMed (the National Library of Medicine), The Cochrane Library, as well as in the research citation databases (Scopus, Web of Science). The etiological factors and features of the pathogenesis of UTIs in pregnant women, as well as diagnostic standards, are described. The current guidelines for the treatment and prevention of UTIs in pregnant women are considered and antibacterial therapy regimens with current dosage forms are presented. The benefits of using cefixime dispersible forms are described in detail.