T.P. ZEFIROVA¹, M.E. ZHELEZOVA¹, I.I. AKHMETSHINA²

¹KSMA – Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

²Municipal Clinical hospital №7, 54 Chykov Str., Каzan, Russian Federation, 420103

Zefirova T.P. ― D. Sc. (medicine), Professor of the Department of Obstetrics and Gynecology №1, e-mail: tzefirova@gmail.com, ORCID ID: 0000-0001-6785-6063

Zhelezova M.E. ― PhD (medicine), Associate Professor of the Department of Obstetrics and Gynecology №1, tel.: (843) 236-34-51, e-mail: gelezovam@gmail.com, ORCID ID: 0000-0002-2006-0110

Akhmetshina I.I. ― doctor of the Maternity Department, tel.: (843) 521-48-01, e-mail: 777.lisichka@mail.ru, ORCID ID: 0000-0001-5756-1579

Objective ― to evaluate the quality of diagnostics and relevance of therapy of asymptomatic bacteriuria in pregnant women.

Material and methods. Medical documents of 1600 pregnant women were analyzed. In 132 cases women had asymptomatic bacteriuria (AB) at various terms of pregnancy. The quality of diagnosing this pathology and the correctness of therapy were analyzed. The features of the course of pregnancy, delivery, and prenatal complications in women with AB were studied.

Results. Asymptomatic bacteriuria (AB) is a frequent complication of pregnancy. However, its true prevalence should be specified, as diagnosing is often done with violated recommendations. According to our data, only 3% of AB diagnoses are undoubtful. In 50% of patients, a one-time urine inoculation was the basis of AB diagnosing, while in 47% ― the clinical analysis of urine. The inaccurate diagnosis led to unjustified (insufficient or excessive) treatment. We found that every fifth pregnant woman with AB diagnosis received no therapy, while 3 out of 4 treated patients used only phytotherapy. Complications of pregnancy were found in 100% of women with AB diagnosis, while 42% of newborns had pathology of early neonatal period. Recently, there appeared scientific data casting doubt on the physiological sterility of bladder and, consequently, the need for AB therapy. The article presents data on the status of women’s urine microbiota and the relevance of curing AB, including in pregnant women. 

Key words: pregnancy, asymptomatic bacteriuria, women’s urine microbiota, diagnosing, treatment, E. coli 83972. 

(For citation: Zefirova T.P., Zhelezova M.E., Akhmetshina I.I. Disputable issues of diagnosing and treatment of asymptomatic bacteriuria in pregnant women. Practical Medicine. 2018)

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