Urinary Tract Infections v/s Other Infections and Their Obstetrics Complications in Pregnant Patients, Admitted in Tertiary Care Hospital in Jaipur, Rajasthan, Indi

Numerous hormonal and mechanical changes in the body occur during pregnancy [1,2]. Ninety percent of pregnant women experience ureteric dilatation, which increases the risk of vesicoureteric reflux and urine stasis. The dilatation begins in the sixth week of gestation and peaks between the 22nd and 24th weeks [3]. Furthermore, during pregnancy, glycosuria and aminoaciduria offer a great growing medium for bacteria in urine stasis sites Pregnant women are more likely to experience UTIs due to these changes, their already narrow urethra,and the difficulty they have maintaining hygiene because of their enlarged tummies. Other infections also occurs during pregnancy but their frequency is less than UTI (urinary tract infection) therefore we conducted a Prospective observational study to prove which type of infection is more common and their obstetrics complications during pregnancy.

Materials and Methods: This is a Prospective observational type of study which was conducted in departments of medicine, obstetrics and gynaecology and nephrology at Mahatma Gandhi Medical College & Hospital in Jaipur Rajasthan over a period of 18 months from June 2022 to December 2023 following receipt of institutional ethics committee approval. In our study 250 pregnant patients who were admitted in the medicine wards, nephrology wards, obstetrics & gynecology wards, and ICUs with symptoms and signs suggestive of infections; age more than 18 years and gave written informed consent were included where as those who passed away before it would have been determined whether they were infected or not were not included.

Methods of Collection of Data: (including sampling procedure)

History
Clinical examinations both general and systemic
Investigations routine blood investigations, fever profile, cultures and sensitivity.
Radiological examinations and other imaging modalities if required with abdominal shielding.
Statistical Analysis: After being input into a Microsoft Excel sheet, all of the data was moved to SPSS software version 17 for analysis. Frequency and percentages were used to present qualitative data.

Results: In our present Prospective observational study the most common age group in study population was from 20 to 24 years (41.7%) followed by ages 25 to 29 years (40%) and then 30 to 35 years (18.3%). We found that most of the study population had a gestational age of 1 to 12 weeks (61.66%) followed by ages 13 to 28 weeks (31.66%) and 6.7% were more than 28 weeks. Similarly majority of the study population had parity two (46.7%) followed by parity one (43.3%), parity three (6.7%) and parity four (3.3%). The most common presenting clinical feature in the study population was fever (accounting 62%) followed by Cough (34%), Headache (32.8%), Nausea (30.8%), Petechiae (26%), Diarrhea (26.8%) and Pain in abdomen (26.4%), the most common type of infections amongst study population was UTI (22.4%) followed by Acute gastroenteritis (21.6%), URTI (18%), Malaria (11.2%) and LRTI (8.4%) Dengue (8%), HBV (6%), Vaginal Candidiasis (5.6%) and HIV (4.8%). We observed that the most common obstetric complications amongst study population was Preterm delivery (15%) thereafter PROM (9%), Abortion (5%), LBW (4%) and IUD (1%), normal vaginal delivery was the most common mode of delivery followed by LSCS (28.2%) and Instrumental delivery (2.6%), most of the study population had birth weight of 2 to 3 kg (66.7%) followed by 3 to 4 kg (25%) and less than 2 kg (8.3%).

Discussion: The most common clinical manifestations of pregnant women with infections were fever followed by cough and headache. The most prevalent kind of infections amongst study population was UTI followed by acute gastroenteritis, URTI. Normal vaginal delivery was the majorly done mode of delivery followed by LSCS and instrumental delivery. The commonly found obstetrics complication in the study population was Preterm delivery followed by PROM and abortion, low birth weight (LBW) and intra uterine death (IUD). Most of the study population pregnancy resulted in babies that had birth weight of 2 to 3 kg followed by 3 to 4 kg and less than 2 kg.

Conclusion: Pregnancy is a state in which the mother's adaptive immunity gradually declines as the pregnancy progresses and with advancing maternal age and related comorbidities, making the mother more susceptible to infections and illnesses.