Commentary - (2023) Volume 10, Issue 2
Received: Mar 22, 2023, Manuscript No. JEBMH-23-99468; Editor assigned: Mar 24, 2023, Pre QC No. JEBMH-23-99468 (PQ); Reviewed: Apr 07, 2023, QC No. JEBMH-23-99468; Revised: Apr 14, 2023, Manuscript No. JEBMH-23-99468 (R); Published: Apr 25, 2023, DOI: 10.18410/jebmh/2023/10/02/82
Citation: Braun M. Gestational Symptomless Bacteriuria (GSB): Risks and Management. J Evid Based Med Healthc2023;10(02):1-2.
Gestational Symptomless Bacteriuria (GSB) is a common condition that occurs during pregnancy, characterized by the presence of bacteria in the urine without any accompanying symptoms. If left untreated, GSB can lead to serious complications for both the mother and the developing fetus.
Causes
During pregnancy, hormonal and anatomical changes in the urinary tract can increase the risk of bacterial colonization and subsequent infection. The most common causative organism is Escherichia coli (E. coli), although other bacteria can also be involved. Risk Factors: Several factors increase the risk of developing GSB during pregnancy, including:
• Previous history of Urinary Tract Infections (UTIs)
• Diabetes mellitus
• Structural abnormalities of the urinary tract
• Sexual activity
• Voiding dysfunction
• History of GSB in previous pregnancies
• Multiparity (having multiple pregnancies)
• Prolonged catheterization
Consequences of Untreated GSB
Pyelonephritis: Untreated GSB can progress to pyelonephritis, a kidney infection. Pyelonephritis is associated with more severe symptoms, such as fever, flank pain, nausea, and vomiting. It increases the risk of preterm labor and can have adverse effects on the fetus.
Preterm birth: GSB has been strongly associated with preterm birth. The presence of bacteria in the urinary tract triggers an inflammatory response that can lead to uterine contractions and premature labor. Preterm birth is a leading cause of neonatal morbidity and mortality.
Low birth weight: Babies born to mothers with untreated GSB are at an increased risk of being born with low birth weight, which is associated with various health complications in infancy and later in life.
Diagnosis
Urine culture: The gold standard for diagnosing GSB is a urine culture. It involves collecting a clean-catch midstream urine sample and sending it to the laboratory for analysis. The presence of a significant number of bacteria in the urine indicates GSB.
Asymptomatic bacteriuria: Asymptomatic Bacteriuria (ASB) refers to the presence of bacteria in the urine without any symptoms. It is diagnosed when significant bacteriuria (defined as ≥10^5 colony-forming units per milliliter) is detected in two consecutive urine samples collected at least 6 hours apart.
Management
Antibiotic treatment: The primary goal of GSB management is to eliminate the bacteria to prevent complications. Antibiotic treatment is the standard approach and is generally safe during pregnancy. The choice of antibiotics depends on the local antibiotic susceptibility patterns and the individual patient's allergies and medical history.
Follow-up urine cultures: After completing antibiotic treatment, follow-up urine cultures should be performed to ensure eradication of the bacteria. This is particularly important in pregnant women, as GSB recurrence can occur.
Screening and prevention: Routine screening for GSB during pregnancy is recommended to identify asymptomatic cases early. This allows for prompt treatment and reduces the risk of complications. Screening is typically performed between 12 and 16 weeks of gestation or during the first prenatal visit if a woman presents later in pregnancy.
Adequate fluid intake: Encouraging pregnant women to maintain adequate fluid intake can help promote regular urination and flush out bacteria from the urinary tract. Drinking plenty of water throughout the day is important for urinary system health.
Indications for treatment: The primary goal of GSB management is to eliminate the bacteria to prevent complications. Antibiotic treatment is the standard approach and is generally safe during pregnancy.
