TY - CHAP T1 - Uncomplicated urinary tract infections in pregnancy T2 - Urogenital Infections and Inflammations AU - Serena, Caterina AU - Tosi, Nicola AU - Mecacci, Federico AU - Petraglia, Felice ED - Naber, Kurt G. AD - Felice Petraglia, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Obstetrics and Gynecology, Florence, Italy, E-mail: felice.petraglia@unifi.it N2 - Urinary tract infections (UTIs) represent a common problem in pregnancy. Asymptomatic bacteriuria (ASB) increases the risk of infection of the upper urinary tract as a consequence of physiological changes. The growing uterus results in urinary retention, in addition maternal hormonal changes (progesterone) relax the ureteral muscle and cause accumulation of urine in the bladder increasing the chance of developing a UTI. Uropathogens responsible for UTIs in pregnancy are the same as those that cause ASB and UTIs in non-pregnant women, with more than 70% of cases supported by E. coli. The two common clinical manifestations are: 1) acute cystitis, generally occurring in the first trimester of pregnancy or 2) pyelonephritis, occurring in the second and third trimesters. The selection of an appropriate antimicrobial agent in pregnancy is limited by the safety not only for the woman, but particularly for the fetus. Acute cystitis should be treated for 3–7 days, but shorter courses of therapy are preferred because of less fetal exposure. The first-line antimicrobial drug is fosfomycin, also in the first trimester. The management of pregnant women with pyelonephritis includes hospital admission for parental fluid and antibiotic therapy with broad-spectrum beta-lactams. After 48 hours, it is usually possible to switch to the oral beta-lactams or trimethoprim-sulfamethoxazole, in the second trimester (at least for 10–14 days). After the first episode of pyelonephritis an antimicrobial urinary suppression and an aggressive follow-up care for the remainder of the pregnancy, due to the high risk of recurrence, are recommended. PY - 2020 DA - 2020/10/12 DO - 10.5680/lhuii000057 LA - en L1 - https://series.publisso.de/en/system/getFile/510 UR - https://dx.doi.org/10.5680/lhuii000057 L2 - https://dx.doi.org/10.5680/lhuii000057 PB - German Medical Science GMS Publishing House CY - Berlin ER -