QuestionSBA
QuestionChoice
Intrapartum antibiotics would be indicated if this person's urine had grown a group B streptococcus.
49869
c
Advise intrapartum antibiotics
QuestionChoice
This would be the first-line treatment for symptomatic urinary tract infection in the non-pregnant person. Trimethoprim is not recommended in pregnancy, particularly in the first trimester.
49870
d
Trimethoprim 200mg twice daily for three days
QuestionChoice
Unless sensitivities dictate otherwise, oral nitrofurantoin is the first-line antibiotic for asymptomatic bacteriuria in pregnant women.
49867
a
Treat with oral nitrofurantoin 100 mg modified-release tablets twice a day for seven days
QuestionChoice
Asymptomatic bacteriuria should be treated in pregnancy. Without treatment, up to 35% of pregnant women with asymptomatic bacteriuria will develop a symptomatic urinary tract infection or pyelonephritis.
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e
Reassure if not symptomatic, the bacteria is a likely contaminant and does not require treatment
QuestionChoice
Unless sensitivities dictate otherwise, oral nitrofurantoin is the first-line antibiotic for asymptomatic bacteriuria in pregnant women. A seven-day course is required in pregnancy.
49868
b
Treat with amoxicillin 500 mg three times a day for five days
QuestionComment
if it was a 3rd trimester UTI presumably you would give nitrofurantoin?
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QuestionComment
3rd trimester is amoxicillin i believe 
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Teslima
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cefalexin methinks
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Inpatient Syndrome
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# Summary

Asymptomatic bacteriuria in pregnancy refers to a positive urine culture in pregnancy without symptoms of a urinary tract infection (UTI). It is critical to treat this condition, as it can increase the risk of spontaneous miscarriage and preterm labour. Treatment typically involves antibiotics, such as nitrofurantoin or cefalexin. In cases where group B streptococcal bacteriuria is identified, intrapartum prophylactic antibiotics are necessary to reduce the risk of transmission to the foetus during labour. 


# Definition



Asymptomatic bacteriuria in pregnancy is a clinical condition where a significant amount of bacteria is present in the urine of a pregnant woman, without the presence of symptoms indicative of a urinary tract infection. This is characterised by a positive urine culture in the absence of UTI symptoms.  


# Signs and Symptoms



Asymptomatic bacteriuria is usually characterised by the absence of symptoms. However, when present, symptoms may be similar to those of a urinary tract infection:

- Frequent urination
- Discomfort during urination
- Lower abdominal pain
- Fever
- Hematuria


# Differential Diagnosis


The main differential diagnoses for asymptomatic bacteriuria in pregnancy include:

- Urinary tract infection: Characterised by dysuria, frequency, urgency, lower abdominal pain, and fever.
- Pyelonephritis: Characterised by fever, flank pain, nausea, vomiting, and urinary symptoms such as frequency and dysuria.
- Bladder infection (cystitis): Characterised by dysuria, frequency, urgency, and lower abdominal pain.


# Management

 

Managing asymptomatic bacteriuria in pregnancy involves treating the condition with antibiotics. Nitrofurantoin and cefalexin are commonly used in this context. If group B streptococcal bacteriuria is identified, the mother will require intrapartum prophylactic antibiotics to reduce the risk of transmission to the foetus during labour.

# External links

[- NICE Clinical Knowledge Summary (CKS): Scenario: Asymptomatic bacteriuria in pregnancy](https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/management/asymptomatic-bacteriuria-in-pregnancy/).
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Asymptomatic bacteriuria in pregnancy
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Obstetrics
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Asymptomatic bacteriuria in pregnancy
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Asymptomatic bacteriuria in pregnancy
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Asymptomatic bacteriuria in pregnancy
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Quesmed Tutorial: Obstetrics 2
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A 24-year-old woman is asked to provide a repeat urine sample after attending her booking appointment at 12 weeks gestation. Her midwife explains that her first urine sample had grown an e-coli in the culture.

The woman has no urinary symptoms and is otherwise entirely well.

What is the most appropriate management plan if the second sample also shows bacteriuria?
a