Complications and treatment of urinary tract infections during pregnancy.

Bacteriuria during pregnancy may result in serious complications, including development of acute pyelonephritis in the third trimester and premature labor. Because uninfected women commonly experience symptoms associated with urinary tract infections and many bacteriuric women are asymptomatic, all pregnant women should be screened by quantitative urine cultures. The goal of antimicrobial therapy is complete elimination of bacteria from the urinary tract. Major indications for complete urologic evaluation are failure of a patient with signs of acute upper-tract infection to improve on appropriate treatment and bacterial persistence after initial sterilization of the urine. Either problem may require surgical intervention.