Optimization of methods for the diagnosis and treatment of urinary tract infections in pregnant women

Maternal mortality is the most important indicator of womens health, but its level is still high. In 2018, 146 cases of maternal death were registered in the Russian Federation. Its main causes were extragenital diseases, bleeding, preeclampsia and eclampsia, amniotic fluid embolism, clinical narrow pelvis, and unsafe abortion. The aim of this study was to assess the structure of maternal mortality in recent years and to evaluate possible ways to reduce it. This was achieved by using an analytical method including carrying out a detailed systematic analysis of modern domestic and foreign literature on the maternal mortality issue. The study used databases such as eLIBRARY.RU, Scopus, PubMed, MEDLINE, ScienceDirect, and Cochrane Library from the creation until July 2021. The measures adopted so far do not allow for counting on a further decrease in maternal mortality rate, therefore the coming decade requires the introduction of artificial intelligence technologies.

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Maternal mortality: structure and solutions to the problem

Зиганшин

Nagimova

Marakanov

et al. 2021

Z.akus.zen.bolezn

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Urinary tract infections in pregnant women

Degtyareva,

Romanova

2024

Medicinskij sovet

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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.

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Topical aspects of laboratory diagnosis of urinary tract infections in pregnancy (literature review)

Štěpánková

Sukhorukova

Kretchikova

2022

Medicinskij alfavit

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Numerous scientific studies, as well as practical experience in public health, have determined that proper and timely diagnosis of urinary tract infection (UTI) during pregnancy often determines obstetric and perinatal outcomes, and affects maternal and perinatal mortality rates. Urinary tract infections are common, with a prevalence in pregnancy ranging from 8 to 10%. During pregnancy and delivery, patients with UTIs can develop a number of complications such as anaemia, spontaneous miscarriage, preeclampsia, fetoplacental insufficiency, premature delivery and postpartum septic complications. UTIs also have adverse effects on the fetus, causing fetal hypoxia, delayed intrauterine development and intrauterine infection. Prenatal screening for UTIs is included in the standard of care for pregnant women throughout the world and in some countries, women are screened more than once. Such early diagnosis for asymptomatic bacteriuria is thought to reduce obstetric, perinatal and urological complications by up to a factor of five. However, in some European countries, the socioeconomic feasibility of routine screening of pregnant women for asymptomatic bacteriuria has recently been raised.

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Optimization of methods for the diagnosis and treatment of urinary tract infections in pregnant women

Cited by 4 publications

References 5 publications

Maternal mortality: structure and solutions to the problem

Maternal mortality: structure and solutions to the problem

Urinary tract infections in pregnant women

Topical aspects of laboratory diagnosis of urinary tract infections in pregnancy (literature review)

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