Screening for Asymptomatic Bacteriuria in Pregnancy

Dr.Abdulrazak Abyad
Tripoli,Lebanon,P.O Box 618, Abyad Medical Center.

The Journal of Family Practice, 1991; 33( 5): 471-74.

Background: Asymptomatic bacteriuria is common during pregnancy. Its average prevalence is 6%. It is an important risk factor for acute pyelonephritis, hypertension, preeclampsia, fetal wastage, low birth weight and prematurity. This study was performed to determine the usefulness of urine microscopy as a substitute for screening urine culture.

Methods: The medical records of all first trimester obstetric visits from 1984 to 1990 were reviewed at a major university. The results of 888 screening urinalyses were recorded and compared to those of subsequent urine cultures.

Results: Fifty-four cultures had growth of a single organism with a level of bacteria of at least 1000 organisms per ml. In the prediction of a positive culture, the microscopic findings of four or more leukocytes per high power field (HPF) showed a sensitivity of 94.4% and a specificity of 95.0%.

Conclusion: Physicians should test the urine samples of all prenatal patients at their first visit and send to the laboratory only those specimens with greater than four leukocytes per HPF. Using this method, unnecessary screening urine cultures will be substantially reduced.