A cross sectional study to establish the prevalence of urinary tract infection in preterm labour

Abstract

Introduction: The perinatal morbidity and mortality are 2-7 times more than that of term pregnancy. Preterm neonate suffers many complications during and after delivery. Hence early diagnosis and management of etiological factors is necessary. Preterm births are multifactorial in origin. Chorioamniotis, UTI, anatomical defect of uterus, placental abnormalities and defect in conceptus are the important known causes of preterm labour. Hydramnios, multiple pregnancy, malpresentation, serious maternal disease, psychological problems are other etiological factors. Materials and Methods: A cross sectional study was conducted at Department of Obstetrics and Gynecology, Hazaribagh Medical College, Hazaribagh from January 2020 to December 2020 (1 year). Detailed clinical history including age of patient, level of education, duration of antenatal care, parity, obstetrical history was taken. Gestational age was calculated from menstrual history from the first day of the last menstrual period in a 28 days cycle and/or early ultrasound examination. General examination, systemic examination and obstetric examination were done. Investigations such as Hb, Total leucocyte count, Blood sugar, Blood grouping, HIV, Hbsag, VDRL were carried out. Clean catch midstream urine samples were collected from all patients in a sterile container. Two samples were thus collected: 1st sample for microscopic examination, 2nd sample for culture and sensitivity. Results: Out of 264 cases of preterm labour studied the prevalence of UTI in preterm labour was 30.1%. Majority of respondents were between age 25-29 years which was 49.4%. Most of the patients were booked as in 77.2% of cases. Around 91.8% were from rural background. Around 75.9% belonged to the lower socio-economic class. It was found in my study that UTI was more prevalent in multipara. Prevalence of UTI among illiterates was as high as 92.4%. Majority of the respondents belonged to late preterm with period of gestation from 34 to 37 weeks. E-coli were the most common organism isolated in urine culture which accounted for 69% of the samples. Out of the cases studied only 1.3% were complicated by pyelonephritis. Conclusion: It can be concluded that all pregnant women should be screened for UTI and treated with appropriate antibiotics if the culture is positive and then retested for cure to prevent complications. In addition, health education to all pregnant females specifically those of low socio-economic class will help in preventing urinary tract infections.