Urinary tract infection in pregnancy

Uvod: Okužbe sečil so za okužbami dihal druge najpogostejše. Ženske so zaradi same anatomije bolj dovzetne za okužbo sečil. Po nekaterih podatkih, jo približno 10–20 % vseh žensk v svojem življenjskem obdobju tudi doživi. Samo v času nosečnosti je incidenca okoli 8 %. Okužba sečil predstavlja dodaten dejavnik tveganja zaradi obsežnih fizioloških sprememb že na začetku nosečnosti. Namen: Namen diplomskega dela je predstaviti okužbe sečil pri ženskah v času nosečnosti, opisati dejavnike tveganja in vlogo medicinske sestre pri zdravljenju ter preventivi okužbe sečil. Metode dela: Za izdelavo diplomskega dela smo uporabili deskriptivno metodo dela, narejen je bil pregled slovenske in angleške strokovne in znanstvene literature. Podatke za izdelavo smo zbirali od marca 2020 do septembra 2020. Literaturo smo iskali v podatkovnih bazah CINAHL, Medline/PubMed, ScienceDirect in preko oddaljenega dostopa Digitalne knjižnice Slovenije (dLib.si) ter spletnega brskalnika Google učenjak. V pregled smo vključili 24 člankov. Rezultati: Zaradi sprememb, ki so povezane z mehanskim pritiskom gravidne maternice in učinkom progesterona, ter z višjo koncentracijo glukoze in pH v urinu, so okužbe sečil najpogostejša okužba v nosečnosti. V vsakem od treh trimesečij so bolj razširjene Gram negativne bakterije (93,7 %), kot Gram pozitivne (6,3 %) bakterije. Med nosečnostjo je prevladujoči mikrobni povzročitelj E.coli, ki predstavlja 80–90 % okužb. Raziskave so pokazale, da lahko bakterijska kolonizacija sečil v nosečnosti povzroči škodljive rezultate za zdravje pri nosečnicah in plodu, zato je trenutno vodenje okužb v nosečnosti s kratkim potekom antibiotikov, ne glede na to, ali je okužba simptomatska ali ne. Kljub temu lahko zdravljenje nosečnic z antibiotiki vpliva tudi na razvoj ploda in njegov imunski sistem. Za preprečevanje okužb sečil, je zelo pomembna pravilna higiena spolovila in zdravo prehranjevanje. Raziskave so pokazale, da imajo brusnice in vitamin D koristne učinke proti pojavom okužb sečil. Razprava in zaključek: Za preprečevanje okužb sečil, zmanjšanje obolevnosti nosečnic ter umrljivosti novorojenčkov, so bistvenega pomena zdravstvena vzgoja, zgodnje prepoznavanje in ustrezno zdravljenje. Torej tu imajo zelo veliko vlogo medicinske sestre, ki morajo delovati zdravstveno-vzgojno in nosečnice poučiti o pravilni osebni higieni ter pravilnem prehranjevanju.Introduction: Urinary tract infections are the most common infectious diseases after respiratory infections. Women are more susceptible due to the anatomy itself, and according to some data, about 10-20% of all women experience a symptomatic urinary tract infection during their lifetime. Only during pregnancy, however, the incidence is about 8%. This is an additional risk factor due to extensive physiological changes in early pregnancy. Purpose: The purpose of the diploma work is to present urinary tract infections in women during pregnancy, to describe risk factors and the role of the nurse in the treatment and prevention of urinary tract infections. Methods: In the diploma work we used the descriptive method with a review of Slovenian and English professional and scientific literature. Data for production were collected from March 2020 to September 2020. We searched for literature in CINAHL, Medline/PubMed, ScienceDirect databases and via remote access of the Digital Library of Slovenia (dLib.si) and the Google Scholar web browser. We included 24 articles in the review. Results: UTIs are the most common infection in pregnancy, due to changes associated with pregnant uterine pressure and the effects of progesterone. It is also affected by higher concentration and pH in the urine. In each of the three trimesters, Gram-negative bacteria (93.7%) are more prevalent than Gram-positive (6.3%) bacteria. The most common microbial pathogen during pregnancy is E. coli, which accounts for 80-90% of infections. Studies have shown that bacterial colonization of the urinary tract in pregnancy can cause detrimental health results in pregnant women and the fetus. Therefore, the current management of UTIs in pregnancy is with a short course of antibiotics, whether the infection is symptomatic or not. Nevertheless, treatment of pregnant women with antibiotics can also affect the development of the fetus and its immune system. Proper genital hygiene and a healthy diet are very important to prevent urinary tract infections. Studies have shown that cranberries and vitamin D have beneficial effects against the occurrence of UTIs. Discussion and conclusion: Health education, early identification and appropriate treatment are essential to prevent UTIs, reduce morbidity and mortality in newborns. So nurses are very important as they have to work health education and teach pregnant women about proper personal hygiene and proper nutrition