Enhanced urinalysis in the detection of asymptomatic bacteriuria in pregnancy

Abstract

Background: Detection and treatment of asymptomatic bacteriuria (ASB) in pregnancy is important to avert the attendant maternal and fetal morbidity. Other than urine culture, no other screening test is unequivocal.

Objective: The use of enhanced urinalysis test to detect ASB in pregnancy was investigated.

Methods: This was a prospective observational study which compared enhanced urinalysis with dipstick tests and urine culture. Clean catch midstream urine specimen was collected from 150 consecutive asymptomatic pregnant women. Tests of validity were used for comparison.

Results: Enhanced urinalysis detected bacteriuria as much as urine culture (4% vs. 4.7%). It was 57.1% sensitive and 98.6% specific. It had a false negative rate of 42.9% and was 96.7% accurate when compared to urine culture. Enhanced urinalysis took 1-2 hours to be done and required skills to use the microscope and was more expensive than dipstick urinalysis.

Conclusion: The accuracy of enhanced urinalysis and its ability to detect ASB as much as urine culture connotes that it can be used to detect asymptomatic bacteriuria in pregnancy albeit only in secondary and tertiary health centres because of the cost and technicality involved.

Keywords: Asymptomatic bacteriuria, UTI in pregnancy