Obstetrics & Gynecology>>>>>Medical and Surgical Complications of Pregnancy
Question 8#

An 18-year-old G1 is diagnosed with asymptomatic bacteriuria (ASB) at her first prenatal visit at 15 weeks’ gestation, based on a urine culture performed as part of her routine new OB laboratory findings.

What is the next step in management?

A. Because she is asymptomatic, she does not require treatment
B. She will only require treatment for ASB if she has sickle cell trait
C. She only requires treatment if the culture is positive for group B streptococcus
D. Twenty-five percent of women with ASB subsequently develop an acute symptomatic urinary infection during the same pregnancy, and therefore she should be treated with antibiotics
E. She does not require treatment because ASB is not associated with adverse pregnancy outcomes

Correct Answer is D

Comment:

The term ASB is used to indicate persistent, actively multiplying bacteria within the urinary tract without symptoms of a urinary infection. The reported prevalence during pregnancy varies from 2% to 7%. The highest incidence has been reported in black multiparas with sickle cell trait and the lowest incidence among white women of low parity. In women who demonstrate ASB, the bacteriuria is typically present at the time of the first prenatal visit; after an initial negative culture of the urine, fewer than 1% develop a urinary infection. If ASB is not treated during pregnancy, approximately 25% of infected women develop an acute infection. Untreated ASB has been associated with an increase in complications such as low birth weight, preterm birth, and pyelonephritis.