Non-symptomatic bacteriuria and pregnancy

26.06.2020

Asymptomatic bacteriuria during pregnancy has been associated with an increased risk of pre-term delivery and low birth weight. In addition, if untreated, 20-40% of pregnant women with asymptomatic bacteriuria may develop pyelonephritis later in pregnancy. Antibiotic treatment for asymptomatic bacteriuria is therefore indicated in pregnant women to reduce the risk of pyelonephritis.

A urine culture should be used to screen for asymptomatic bacteriuria at 12 to 16 weeks gestation. Women who do not have bacteriuria in the first screen do not need to have repeat urine culture during the remaining of the pregnancy.

It is recommended that all pregnant women who have confirmed asymptomatic bacteriuria are treated with antibiotics for seven days to ensure cure. A repeat culture one to two weeks after completing therapy is required to ensure the eradication of bacteriuria. It is then recommended that urine cultures are repeated regularly until delivery. 

Group B streptococcus: Even when treated, group B streptococcus bacteriuria is associated with heavy vaginal colonisation and therefore an increased risk of neonatal group B streptococcus disease. Pregnant women found to have group B streptococcus infection in the urine should be treated at the time of diagnosis and prophylaxis is given during delivery.