DATE: October 23, 2019

SUMMARY
ASSOCIATION OF MATERNAL LOWER URINARY TRACT INFECTION WITH ADVERSE
FETAL OUTCOME IN TERMS OF PRETERM LABOR AND LOW BIRTH WEIGHT 


Preterm labor is a leading cause of neonatal morbidity and mortality. A lot of factors are considered to
have association with the occurrence of pre-term labor, one of these is urinary tract infection. Evidence
suggests that infection plays a role in pathogenesis of preterm labor and delivery. The infection of the
urinary system is one of the most prevalent bacterial infections occurring during pregnancy. The infection
itself and its treatment may cause unwanted effects on the pregnancy. Thus, This study was designed to see
the association between and urinary tract infections and adverse fetal outcomes in terms of pre term labor
and low birth weight.

This descriptive, cross-sectional study was performed involving all primigravida pregnant women of
age between 20- 35 years, with lower urinary tract symptoms presenting after 24 weeks with one or more
episodes of UTI. Women with any of the following causes of acute abdomen were excluded from the study
including patients with acute appendicitis, ruptured abdominal aneurysm, peritonitis, pancreatitis,
cholecystitis, ruptured spleen or ruptured ovarian cyst. Mid-stream urine samples were collected for culture
and sensitivity. Each woman was instructed by a staff nurse regarding the proper collection of the urine
sample. Patients with positive report of urine C/S due to any pathogen was found, were included in the
study. These patients were followed up further, in their index pregnancy to identify the prevalence of fetal
complications like reduced fetal weight or chances of going in preterm delivery. Preterm labour was
considered if delivery was done at < 37wks and low birth weight was considered if weight is<2500gms.

A total of 155 primigravada women with at least one or more episodes of urinary tract infection were
included in this study. In the study patient with diagnosed UTI have shown 30% premature births and 25%
births were with low birth weight. In conclusion, this study has provided significant information on the
relevance of urinary tract infection on adverse fetal outcomes such as preterm labor and low birth weight.

REFERENCE

Iqbal, F., Naqvi K.Z., Ashfaq,S., Memon, E., Aziz,S., Sultan,S., & Irfan, S.M. (2017). Association of
maternal lower urinary tract infection with adverse fetal outcome in terms of preterm labor and low birth
weight. Journal of the Society of Obstetricians and Gynaecologists of Pakistan, 7(1), 33-37.

 DATE: October 23, 2019

SIGNIFICANCE
ASSOCIATION OF MATERNAL LOWER URINARY TRACT INFECTION WITH ADVERSE
FETAL OUTCOME IN TERMS OF PRETERM LABOR AND LOW BIRTH WEIGHT 


Urinary Tract Infection during pregnancy has shown a significant impact on pregnancy outcome. This
infection and its treatment may cause pre-term birth and low birth weight that may pose another risk for
neonatal morbidity and mortality. Recognizing and treating a women having this infections at a stage, when
it has not become clinically evident, will decrease the percentage of women going into preterm labor and
will improve the perinatal outcome. It is a very useful area for interventions to prevent dire neonatal
outcome. Through screening of pregnant women for UTI, we can minimize these UTI associated
complications. As nurses that is responsible for assessing and gathering information, we must be vigilant for
signs and symptoms of Urinary Tract Infection. Typical symptoms of UTI that a nurse should screen for
include: urinary frequency, burning or pain upon urination, incontinence (or increased incontinence), and/
or urinary urgency, increased temperature, suprapubic pain or tenderness, or costovertebral angle pain or
tenderness.

One of the important roles of nurses in all settings is health education. Through the practice of health
education, nurses can provide patients and clients the information they need to manage and ultimately
improve their health. We can teach our clients on ways to prevent the occurrence of urinary tract infection.
We can educate about the importance of perineal hygiene. Our teaching points may include teaching clients
on wiping from front to back after toileting, taking showers over baths, avoiding the use of powder or
irritating feminine products (such as douches and sprays) in the genital area, changing soiled or damp
underwear/pads frequently, , starting and maintain regular and frequent toileting schedules, and teaching
the importance of completely emptying the bladder when urinating. Through this study we can emphasize
the importance of avoiding these infections during pregnancy to prevent adverse possible effects.

Efforts directed at developing and researching new screening tests and preventive measures for
urinary tract infection could lead to significant reductions in the burden that results from the preterm birth
and low birth weight secondary to urinary tract infection. The future researches about these possible
screening tests and preventive interventions could give a significant information on the educational
institutions and can further be enhanced for the promotion of health of our clients. In relation to this study,

REFERENCE

Iqbal, F., Naqvi K.Z., Ashfaq,S., Memon, E., Aziz,S., Sultan,S., & Irfan, S.M. (2017). Association of
maternal lower urinary tract infection with adverse fetal outcome in terms of preterm labor and low birth
weight. Journal of the Society of Obstetricians and Gynaecologists of Pakistan, 7(1), 33-37.

 DATE: October 23, 2019

LEARNING INSIGHTS
ASSOCIATION OF MATERNAL LOWER URINARY TRACT INFECTION WITH ADVERSE
FETAL OUTCOME IN TERMS OF PRETERM LABOR AND LOW BIRTH WEIGHT 


Pregnancy affects every system in our body. Changes in hormone levels and immune system function
can make a pregnant woman more vulnerable to infections and serious complications. Through the study I
have learned the possible adverse fetal outcomes when a pregnant woman has a urinary tract infection. I
have also learned how this infection pose a risk for pre-term birth. Infection may raise release of
inflammatory chemokine’s and cytokines such as interleukins and tumor necrosis factors. Proinflammatory
cytokines stimulate the production of prostaglandins (other inflammatory mediators) and matrix-degrading
enzymes that finally result in stimulation of uterine contractions, preterm rupture of the membrane, and
preterm birth.

This kind of infection poses threat to the mother and fetal outcome. However, this is preventable. The
factors that causes this kind of infection are often modifiable factor. Thus, through correct and close
assessment we can identify the possible cause of the problem and address it. This study has made me
realized the importance of a nurse in preventing diseases. As a nurse, who has the closest contact with the
patient, we can closely assess and educate our clients to avoid these infections and its possible effects.
Through this study we can raise awareness on the importance of staying healthy and staying away of
infection. With our sufficient knowledge, we can provide necessary information that a patient can use to
manage and promote optimal health.

Promoting healthy and hygienic practices in pregnancies are important, since complication that occur
during pregnancy that may pose problems are often modifiable. As a nurse, it is our responsibility to asses
our clients and provide necessary interventions, specifically educational interventions.

REFERENCE

Iqbal, F., Naqvi K.Z., Ashfaq,S., Memon, E., Aziz,S., Sultan,S., & Irfan, S.M. (2017). Association of
maternal lower urinary tract infection with adverse fetal outcome in terms of preterm labor and low birth
weight. Journal of the Society of Obstetricians and Gynaecologists of Pakistan, 7(1), 33-37.

 Saint Louis University

SCHOOL OF NURSING
LEVEL II

JOURNAL SUMMARY, SIGNIFICANCE

AND LEARNING INSIGHTS

Submitted by:
Buenaventura, Maranatha Raquel

Submitted to:
Buenaventura, Maranatha Raquel

October 23, 2019