URINARY TRACT INFECTIONS

A   23-year-old primigravida    at  31  weeks’  gestation   comes   to  the birthing

unit    with    complaints  of  flank   pain,   nausea, vomiting,   and shaking chills  for

the past    12  h.  She has been    diagnosed   with    sickle  cell    trait.  On  examination

her temperature is  39.4    C   (103    F), pulse   125 beats/min,  and respirations    30

breaths/min.    Her skin    is  grossly diaphoretic and she has exquisite   right

costovertebral  angle   tenderness. Electronic  fetal   monitoring  shows   baseline

pulse   170/min with    reactivity. Uterine contractions    are noted   every   10  min.

Urinary tract infections (UTI) may involve the lower tract (including the
bladder or urethra) or upper tract (including the kidney). The most common
organisms are gram-negative enteric bacteria with Escherichia coli the most
frequent.