Grio R, Porpiglia M, Vetro E, Uligini R, Piacentino R, Minì D, Marchino G L
Institute of Gynecology and Obstetrics, University of Turin, Italy.
Panminerva Med. 1994 Dec;36(4):198-200.
From an analysis of the data reported in the literature it is clear that pregnancy is a predisposing factor for urinary tract infection and that pregnant women with this pathology are exposed to dangerous risks which may influence maternal wellbeing and fetal prognosis. Authors do not concur on the specific risks to the mother and fetus, one reason being that the statistics reported to date reveal discrepancies relating to the presence of disorders prior to pregnancy and the environmental, working and socio-hygienic conditions of the populations studied. The apparently paradoxical finding of a higher incidence of perinatal problems in pregnant women with asymptomatic bacteriuria compared to manifest forms can be attributed to the fact that the latter are treated with adequate therapies whereas asymptomatic bacteriuria, which is difficult to diagnose, may persist throughout pregnancy. This underlines the importance of early diagnosis using a protocol which entails the execution of serial urine tests and urine cultures and adequate treatment of all cases of asymptomatic bacteriuria in order to reduce the incidence of urinary tract infections and materno-fetal complications. Non-treated asymptomatic bacteriuria in fact represents a considerable risk factor since it may lead to the onset of acute pyelonephritis in approximately 5% of pregnant women and may increase the risk of fetal mortality.
从对文献报道数据的分析来看，很明显怀孕是尿路感染的一个诱发因素，患有这种病症的孕妇面临着可能影响母体健康和胎儿预后的危险风险。作者们对于对母亲和胎儿的具体风险并未达成共识，一个原因是迄今为止所报告的统计数据显示，在怀孕前疾病的存在以及所研究人群的环境、工作和社会卫生条件方面存在差异。与显性形式相比，无症状菌尿症孕妇围产期问题发生率较高这一明显矛盾的发现，可归因于后者接受了适当治疗，而难以诊断的无症状菌尿症可能在整个孕期持续存在。这凸显了使用一种方案进行早期诊断的重要性，该方案需要进行系列尿液检测和尿培养，并对所有无症状菌尿症病例进行适当治疗，以降低尿路感染和母婴并发症的发生率。未经治疗的无症状菌尿症实际上是一个相当大的风险因素，因为它可能导致约5%的孕妇发生急性肾盂肾炎，并可能增加胎儿死亡风险。
