Skip to main content
NCBI home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1992 Feb;68(1):39–41. doi: 10.1136/sti.68.1.39

Urogenital tract infections in pregnancy at King Edward VIII Hospital, Durban, South Africa.

M Dietrich 1, A A Hoosen 1, J Moodley 1, S Moodley 1
PMCID: PMC1194796  PMID: 1548010

Abstract

OBJECTIVES--To evaluate the role of detecting asymptomatic bacteriuria and endocervical infections in the black prenatal patients attending King Edward VIII Hospital (KEH), Durban, with the view of justifying a screening programme. Screening for syphilis and human immunodeficiency virus (HIV) infection were also evaluated. SUBJECTS--181 asymptomatic black prenatal patients attending the antenatal clinic for their first antenatal visit volunteered for the study and gave their written consent. DESIGN--Examination of each prenatal patient included obtaining of endocervical swabs to detect endocervical infections (C trachomatis, N gonorrhoeae), serum for syphilitic and HIV testing, and a midstream specimen of urine for microscopy and culture. RESULTS--Asymptomatic bacteriuria was found in 5.6% of patients in this study. Cervical infections were diagnosed microbiologically in 8.2% of women. These were N gonorrhoeae in 4.1% and C trachomatis in 4.7%. Serological tests for sexually transmitted diseases showed the presence of syphilis in 7.6% and antibody to the HIV in 1.9%. Overall, one or more sexually transmitted diseases were found in 16.5% of the women studied. CONCLUSIONS--This study suggests that all women presenting for routine antenatal care in a setting such as Durban should be screened for lower genital tract infections. Ideally this should include a midstream urine specimen for culture, serum for syphilitic and HIV antibody testing and endocervical swabs for sexually transmitted pathogens. In developing communities, however, more reliable and cheaper methods of endocervical screening need to be available before antenatal screening for cervico-vaginal infections can be justified.

Full text

PDF
39

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Braddick M. R., Ndinya-Achola J. O., Mirza N. B., Plummer F. A., Irungu G., Sinei S. K., Piot P. Towards developing a diagnostic algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae cervicitis in pregnancy. Genitourin Med. 1990 Apr;66(2):62–65. doi: 10.1136/sti.66.2.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brunham R. C., Paavonen J., Stevens C. E., Kiviat N., Kuo C. C., Critchlow C. W., Holmes K. K. Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men. N Engl J Med. 1984 Jul 5;311(1):1–6. doi: 10.1056/NEJM198407053110101. [DOI] [PubMed] [Google Scholar]
  3. Chng P. K., Hall M. H. Antenatal prediction of urinary tract infection in pregnancy. Br J Obstet Gynaecol. 1982 Jan;89(1):8–11. doi: 10.1111/j.1471-0528.1982.tb04625.x. [DOI] [PubMed] [Google Scholar]
  4. Clay J. C. Antenatal screening for syphilis. BMJ. 1989 Aug 12;299(6696):409–410. doi: 10.1136/bmj.299.6696.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fransen L., Nsanze H., Klauss V., Van der Stuyft P., D'Costa L., Brunham R. C., Piot P. Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. J Infect Dis. 1986 May;153(5):862–869. doi: 10.1093/infdis/153.5.862. [DOI] [PubMed] [Google Scholar]
  6. Hillier S. L., Martius J., Krohn M., Kiviat N., Holmes K. K., Eschenbach D. A. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med. 1988 Oct 13;319(15):972–978. doi: 10.1056/NEJM198810133191503. [DOI] [PubMed] [Google Scholar]
  7. Hoosen A. A., Ross S. M., Mulla M. J., Patel M. The incidence of selected vaginal infections among pregnant urban blacks. S Afr Med J. 1981 May 30;59(23):827–829. [PubMed] [Google Scholar]
  8. KASS E. H. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56–64. [PubMed] [Google Scholar]
  9. KASS E. H. Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic. AMA Arch Intern Med. 1957 Nov;100(5):709–714. doi: 10.1001/archinte.1957.00260110025004. [DOI] [PubMed] [Google Scholar]
  10. KASS E. H. Chemotherapeutic and antibiotic drugs in the management of infections of the urinary tract. Am J Med. 1955 May;18(5):764–781. doi: 10.1016/0002-9343(55)90190-x. [DOI] [PubMed] [Google Scholar]
  11. Manning B., Moodley J., Ross S. M. Syphilis in pregnant black women. S Afr Med J. 1985 Jun 15;67(24):966–967. [PubMed] [Google Scholar]
  12. McNeeley S. G., Jr Treatment of urinary tract infections during pregnancy. Clin Obstet Gynecol. 1988 Jun;31(2):480–487. doi: 10.1097/00003081-198806000-00022. [DOI] [PubMed] [Google Scholar]
  13. Naicker S. N., Moodley J., van Middelkoop A., Cooper R. C. Serological diagnosis of syphilis in pregnancy. Experiences at King Edward VIII Hospital, Durban. S Afr Med J. 1983 Apr 2;63(14):536–537. [PubMed] [Google Scholar]
  14. Norden C. W., Kass E. H. Bacteriuria of pregnancy--a critical appraisal. Annu Rev Med. 1968;19:431–470. doi: 10.1146/annurev.me.19.020168.002243. [DOI] [PubMed] [Google Scholar]
  15. O'Farrell N., Hoosen A. A., Kharsany A. B., van den Ende J. Sexually transmitted pathogens in pregnant women in a rural South African community. Genitourin Med. 1989 Aug;65(4):276–280. doi: 10.1136/sti.65.4.276. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. O'Farrell N., Windsor I., Becker P. HIV-1 infection among heterosexual attenders at a sexually transmitted diseases clinic in Durban. S Afr Med J. 1991 Jul 6;80(1):17–20. [PubMed] [Google Scholar]
  17. Schaefer C., Harrison H. R., Boyce W. T., Lewis M. Illnesses in infants born to women with Chlamydia trachomatis infection. A prospective study. Am J Dis Child. 1985 Feb;139(2):127–133. doi: 10.1001/archpedi.1985.02140040025019. [DOI] [PubMed] [Google Scholar]
  18. Shortliffe L. M. Asymptomatic bacteriuria: should it be treated? Urology. 1986 Feb;27(2 Suppl):19–25. [PubMed] [Google Scholar]
  19. Stamm W. E., Counts G. W., Running K. R., Fihn S., Turck M., Holmes K. K. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982 Aug 19;307(8):463–468. doi: 10.1056/NEJM198208193070802. [DOI] [PubMed] [Google Scholar]
  20. Wager G. P., Martin D. H., Koutsky L., Eschenbach D. A., Daling J. R., Chiang W. T., Alexander E. R., Holmes K. K. Puerperal infectious morbidity: relationship to route of delivery and to antepartum Chlamydia trachomatis infection. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):1028–1033. doi: 10.1016/0002-9378(80)91102-3. [DOI] [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES