Management of microbacteriuria during pregnancy

• Irina Yu. Breslav
• Madina M. Umakhanova
• Olga A. Koroleva

Abstract

Bacterial urinary tract infections (UTIs) are among the most common inflammatory complications of pregnancy. Symptomatic forms (cystitis, pyelonephritis), asymptomatic bacteriuria (bacterial titer in two consecutive culture studies ≥10⁵ CFU/ml, for group B streptococcus ≥10⁴ CFU/ml) and mycobacteriuria (asymptomatic isolation of bacteria in a titer ≤10⁴ CFU/ml) should be distinguished.

The aim of the study was to propose optimal management strategy for pregnant patients with mycobacteriuria who have an complicated urological history.

Results. Among 20 patients with mycobacteriuria at 14⁰–34⁰ weeks of gestation, the most frequently isolated microbial agents were E. coli (40%) and Enterococcus faecalis (40%). 75% of pregnant women reported a history of urinary tract diseases. Against the background of taking the dietary supplement Lactoflorene resulted in no cases of pyelonephritis. Persistent bacteriuria was observed in 5% of cases. Transformation of mycobacteriuria into cystitis was recorded in 10% of pregnant women. All patients delivered at full-term 39 (38; 40) weeks with live babies weighing 3500 (3200; 3810) g in satisfactory condition. Caesarean section was performed in 30% of cases. The postpartum period was uneventful.

Conclusion. Current guidelines do not provide clear management strategies for pregnant women with microbacteriuria, which is often combined with acute and chronic diseases of the urinary system. Parapharmaceuticals, like Lactoflorene, may prevent the progression to symptomatic infections, especially in the category of patients with a complicated urological history. The absence of regulatory standards for dietary supplements limits their use in personalized treatment approaches.

Keywords: asymptomatic bacteriuria; pregnancy; urinary tract infection

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