Clinical Profile and Risk Factors of Urinary Tract Infection Among Pregnant Women During First Trimester

Abstract

Background : Risk factors of Pregnancy is a stress that may reveal a variety of medical conditions which includes hypertension, metabolic syndrome, pre-eclampsia, gestational diabetes and ischemic heart disease etc. Urinary tract infection in first trimester is not uncommon with different risk factors. So the objective of the present study was to describe the clinical profile and risk factors of urinary tract infections during 1st trimester of pregnancy. Materials and methods: A descriptive study was conducted in the Obstetric and Gynaecology Department of BGC Trust Medical College Hospital, Chittagong from 1st January to 30th August 2016. Total 100 women were selected to ascertain the frequency and pattern of urinary symptoms as well as the risk factors of Urinary Tract Infection (UTI) such as age, parity, past history of UTI and haemoglobin among women attending an antenatal clinic. All pregnant women at 1st trimester irrespective of age, parity and gestational age were included, while women with known underlying renal pathology, chronic renal disease, renal transplant, diabetes or taking immunosuppressant therapy were excluded. Informed consent was taken and data collected on a self designed proforma. All the women underwent complete examination of urine. Dipstick test was performed on midstream urine and urine was cultured incase of positive dipstick test and women with urinary symptoms. Data was analyzed on SPSS version 18. Results: Regarding age distribution of the patients and found more than a half (52.0%) of patients belonged to 20–25 years age group. The mean (±SD) age of the patients was 23.7±4.5 years with range from 16 to 32 years. Regarding the general examination it was observed that anxious was found 55(55.0%), mild anaemia 59(59.0%), fever 25(25.0%) and high respiratory rate 16(16.0%). Build, nutritional status, lungs and examination of breast shows normal of the studied patients. The mean (±SD) Hb% of the patients was 10.0±0.6 gm/dl with range from 9 to 11 gm/dl. The mean (±SD) total count of the patients was 8428.6±1746.9/cumm with range from 6000 to 10000 /cumm. The mean (±SD) differential count of the patients was 69.0±3.4% with range from 65 to 75. The mean (±SD) ESR of the patients was 43.6±5.4 mm in 1st hour with range from 30 to 50 mm and the mean (±SD) RBS was 95.7±8.7 mg/dl with range from 90 to120 mg/dl. Pseudomonas 23(23.0%) Klebsilla 15(15.0%) E. coli 45(45.0%) and Proteus 17(17.0%) isolated from urine of UTI after caesarean section cases. Abnormal voiding pattern 87 (40.3%). Illiteracy(15%) History of sexual activity(10%), Low socioeconomic (Monthly income < Tk. 10,000 / month) group(17%) Past history of UTI(5%) and Multiparity(14%) were found to be risk factors for UTI in 1st trimester in these women. Conclusion: The common urinary symptoms encountered in the studied women were abnormal voiding pattern followed by irritative symptoms. Majority of urinary symptoms were due to pregnancy related changes in the urinary system. Past history of UTI, sexual activity, lower socioeconomic group and multi parity were significant risk factors for UTI.

JCMCTA 2017 ; 28 (1) : 21 - 26