Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. Urinary concentrating ability in women with asymptomatic bacteriuria in pregnancy. Use of sulfasymazine in the treatment of bacteriuria of pregnancy. The natural history of asymptomatic bacteriuria during pregnancy: the effect of tetracycline on the clinical course and the outcome of pregnancy. Bacteriuria of pregnancy: results of treatment. Urinary antiseptics in asymptomatic bacteriuria of pregnancy.
The presence of group-B streptococci in the urine of pregnant women seems to be associated with preterm labour. Urine samples from 4122 women at 27-31 weeks' gestation were examined for bacteria. Group-B streptococci were found in the urine of 69 women. In a double-blind, controlled study these patients were given either penicillin (10(6) IU three times daily for 6 days; 37 patients) or placebo (32 patients). The rates of primary rupture of the membranes (11% v 53%; p less than 0.001) and preterm labour (5.4% v 38%; p less than 0.002) were significantly lower in the penicillin group than in the placebo group. These results suggest that treatment and follow-up to prevent recolonisation in pregnant women with group-B streptococci in the urine may reduce the frequency of preterm labour in these patients. The incidence of impaired renal concentrating ability in pregnant women with asymptomatic significant bacteriuria is significantly less than previously reported when osmolality readings are performed on every urine specimen obtained during the 24 hours' deprivation of fluids. The concentrating defect is more considerable as pregnancy progresses. The lower the maximum urinary osmolality the more difficult is the treatment of the patient, and the higher the incidence of acute pyelonephritis. nan nan nan A screening programme for the detection of asymptomatic bacteriuria in patients attending an antenatal clinic is described. The results obtained from the use of urinary antiseptics in a controlled trial over a period of two years are presented. The number of patients developing clinical pyelonephritis, fetal maturity at delivery and birth weight were recorded for treatment and control groups and compared with the equivalent results obtained from the total population of patients seen at the clinic.
Antibiotic treatment is effective in reducing the risk of pyelonephritis in pregnancy. A reduction in low birthweight is consistent with current theories about the role of infection in adverse pregnancy outcomes, but this association should be interpreted with caution given the poor quality of the included studies.