DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205748

Is routine urine dip stick testing justified in asymptomatic women in early pregnancy?

Jonathan Gaughran, Bethany Chung, Tom Lyne, Nuhaat Syeda, Daniel Field, Judith Hamilton

Abstract


Background: Routine urinalysis is commonly performed in early pregnancy units (EPUs) based on historic evidence that bacteriuria is linked to pyelonephritis, pre-term birth, mid trimester loss and low birth weight. Aim was to assess the cost and diagnostic yield of routine urinalysis in asymptomatic women in early pregnancy. A secondary outcome was the birth outcomes for women with proven bacteriuria.

Methods: Retrospective review of all urinalysis performed over 12 month period in a tertiary EPU and analysis of pregnancy outcomes in the proven bacteriuria group.

Results: 10,490 urinalyses performed at a cost of £40,385.50. 1162 (11%) positive urine dips; 68 (0.6%) nitrite positive. 179 microscopy, culture and sensitivity performed at a cost of £2593.71. Of the 179, 65 were culture positive giving a proven bacteriuria rate of 0.6%. The most common pathogen was E-Coli. There were no recorded episodes of pyelonephritis and no statistical significance in the pre-term birth, mid trimester loss or low birth weight rate in the culture positive versus culture negative group.

Conclusions: The cost associated with routine urinalysis is significant and the diagnostic yield is extremely low. We did not identify an association between bacteriuria and adverse pregnancy outcomes. As such, urinalysis should only be performed in symptomatic/ high risk patients presenting to the EPU.


Keywords


Bacteriuria, Early pregnancy, Low birth weight, Miscarriage, Premature, Urinalysis

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