Urology infections during pregnancy are the most common causes of admission to admission to women’s non -productive sections.Urinary infections that are not treated may cause premature birth, purulent leather, adult respiratory distress syndrome, and even death.
Women during pregnancy, once there are related suspicious symptoms and results of urinary infection, such as frequent urination, urgency, dysuria, increased urinary white cells, etc., how should clinicians consider and deal with?
1. What are the aspects of coverage?
• Knowing whether pregnant women are normal during pregnancy.
• Fetal condition: fetal movement (systemic diseases during pregnancy will affect fetal health).
• At present, urinary symptoms: whether there is less urine, frequent urination, urgency, and abdominal pain.The above symptoms may exist in pregnant women, even if there is no urinary infection, urine analysis is an important method for identifying diagnosis.
• Claims of urinary systems with symptoms: whether there are pain and hematuria on pubic bone, identify urine retention and urinary stones.
• History of previous urology infection: Women who have had a history of urinary infection in the past have increased the possibility of urinary infection again during pregnancy.
• Vaginal osmotic: bacterial vaginitis or certain sexual infectious diseases such as chlamydia infection, similar to the symptoms of urinary infections, so you should ask the history of recent sexual life.
• Symptoms of the whole body: fever, cold war, nausea, vomiting, decreased appetite, and changes in mental state (assisted to judge purulent poisonmia).
• Started history: neuropathy, diabetes, other obstetrics and gynecological diseases caused by spinal trauma, and other obstetrics and gynecological diseases.
2. What physical examination do I need to do?
Find whether there is a signs of purulent hemorrhoids:
• Record the temperature, pulse rate, respiratory frequency, blood pressure, and maybe blood oxygen saturation.
• Lumbar and abdomen physical examination: diagnosis of waist, groin and tenderness on the pubic bone, and pecgiarity, etc., to identify urinary retention, urinary stones, and upper urinary tract infections.
• Penal heart rate, if the fetal heart rate is abnormal (the normal range is 100 to 160 times/minute), it should be referred to the obstetrician’s fetal heart monitoring.
What do you need to do and how to deal with it?
• If the patient has a manifestation of systemic or purulent poison, hospitalization should be arranged as soon as possible, and antibiotics are used by veins.Pay attention to urinary system infection with antibiotics and safety during pregnancy.
• All women leave urine microorganisms+medicinal sensitivity.
• Women suspected to be infected with urinary system infection. When there is no systemic symptoms, oral antibiotic treatment is used for 7 days.
• If antibiotic treatment has begun when there is no microbial culture results, the cultivation results need to be tracked closely. If the resistance is found, antibiotics are adjusted in time.For a pregnant woman 36 weeks ago, 7 -day bephytotidal treatment is the first choice for lower urinary tract infections.
• E. coli is the most common pathogenic bacteria for pregnant women’s urinary infections.
• If pain is the main symptom or culture result is atypical urinary infection, such as deformation bacteria and Craber, you need to consider urinary stones, and the first choice of urinary ultrasound examination.
• It is worth noting that the infection of the Bacteria in Group B is related to choricularitis and neonatal disease.Pregnant women have a group B chaincococcal urine, which should be given 7 days of antibiotic treatment, and the use of load penicillin is used to prevent the use of loads, and repeated administration every 4 hours until the delivery is over.
(Supply: Xue Guoqiang, Department of Urology, the Second People’s Hospital of Gansu Province)