임신부에 있어서의 무증후성세균뇨에 관한 연구

Abstract

[한글]

[영문]

Urinary infection in pregnancy has been a known important complication. Asymptomatic bacteriuria, which is rather common however, seems to be payed little attention in obstetrical practice.

The purpose of this paper is to evaluate clinical importance of the asymptomatic bacteriuria during pregnancy. The frequency of asymptomatic bacteriuria, it's relationship to prematurity, toxemia and anemia during pregnancy, early detection in prenatal care, and the prognosis will be discussed. The data to be presented are based on 192 pregnant women (26-45 weeks) seen in Ewha Women's University Hospital, seoul, Korea.

The urine specimens were obtained by catheterization under the strict aseptic manner, and sent to laboratory via refrigarator. There were no over night intervals between collection and culture of the urine specimens. Possible contamination could be avoided without difficulty and the significant organisms were thoroughly

evaluated by means of comparison-analysis and number of bacterias, 100,000/ml or more regarded to as bacteriuria. Pour plato method was employed for the cultures.

The culture medias used were: pepton water, blood agar, MacConkey agar, mannitol salt agar, salmonella-shigella agar, sugar and methylene blue milk etc.

Conclusions

1. The incidence of asymptomatic bacteriuria during pregnancy was 10.4%, and it seemed to be relatively frequency.

2. The most significant organisms found in the asymptomatic bacteriuria were coliform organisms with an incidence of 30%. E. coli was the most predominant one among the organisms.

3. There did not seem to be increased tendency of prematurity in the offspring of bacteriuric patients, although in this study 10% of the prematurity has been shown to be from this cases. The reason for all of them were toxemic and it alone may influence the incidence of pregnancy sufficiently.

4. The incidence of toxemia of pregnancy seemed to be not significantly increased in the bacteriuric patients during pregnancy.

5. There was no significant increase in the incidence of anemia in patients with asymptomatic bacteriuria.

6. There was no difference in the frequency of glycosuria in patients with asymptomatic bacteriuria but a significantly increase in the incidence of proteinuria in these patients. Therefore it seems to be wise to check bacteriuria as a screening method in the prenatal care in case proteinuria appears.

7. There have shown some(15%) episodes of previous urinary tract infection in patients with asymptomatic bacteriuria. Most of the asymptomatic bacteriuria had spontaneously disappeared in 6 months postpartum follow-up. However one of them persists required medical treatment even though there is no evidence of developing pyelonephritis.

The history of urinary tract infection also seemed to be good indication for the detection of unsuspected bacteriuria early in prenatal care. Thus symptomatic acute pyelonephritis can be prevented and reduced.