Información del artículo
Las infecciones del tracto urinario –bacteriuria asintomática (BA), cistitis aguda (CA) y pielonefritis aguda (PA)– son favorecidas por los cambios morfológicos y funcionales del embarazo. La BA aumenta el riesgo de parto pretérmino, de bajo peso al nacimiento y de PA. Se debe detectar mediante urocultivo (otros métodos no son suficientemente eficaces) y tratar precozmente. Escherichia coli causa alrededor del 80% de los casos. Se deben valorar los riesgos y la eficacia de las distintas pautas antibióticas: la fosfomicina-trometamol en monodosis o pauta corta resulta eficaz y segura para el tratamiento de la BA y la CA. La PA es la razón más frecuente de hospitalización por causa médica en la embarazada y puede complicarse en el 10% de los casos, poniendo en riesgo la vida fetal y la materna. Actualmente se propone el tratamiento ambulatorio de la PA en casos seleccionados. Es necesario un adecuado seguimiento de las gestantes con infección del tracto urinario (ITU) por las frecuentes recurrencias.
Palabras clave:
Infección del tracto urinario
Embarazo
Antibióticos
Bacteriuria asintomática
Pielonefritis aguda
Urinary tract infections, asymptomatic bacteriuria (AB), acute cystitis (AC) and acute pyelonephritis (AP), are favored by the morphological and functional changes involved in pregnancy. AB increases the risk of preterm labor, low birth weight and AP. AB should be detected by uroculture (other methods are not sufficiently effective) and treated early. Approximately 80% of cases are caused by Escherichia coli. The risks and effectiveness of the distinct antibiotic regimens should be evaluated: fosfomycin trometamol in monotherapy or as short course therapy is safe and effective for the treatment of AB and AC. AP is the most frequent cause of hospital admission for medical reasons in pregnant women and can lead to complications in 10% of cases, putting the lives of the mother and fetus at risk. Currently outpatient treatment of AP is recommended in selected cases. Adequate follow-up of pregnant women with urinary tract infections is required due to frequent recurrence.
Key words:
Urinary tract infection
Pregnancy
Antibiotics
Asymptomatic bacteriuria
Acute pyelonephritis
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