Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 161: A 28-Year-Old Pregnant Woman with an Abnormal Urinalysis
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Aug 28, 2025 Listeners dive into the intriguing case of a pregnant woman with abnormal urinalysis, highlighting the complexities of urinary tract infections. The discussion covers the prevalence and gender differences in UTIs, focusing on the unique challenges faced by pregnant patients. Importance is placed on managing asymptomatic bacteriuria to prevent serious complications. The necessity of prompt treatment and urine dipstick tests is emphasized, making the podcast a must-listen for anyone interested in women's health issues.
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Negative Dipstick Doesn’t Rule Out Bacteriuria
- Asymptomatic bacteriuria in pregnancy can exist despite a negative dipstick and has major clinical implications.
- Detecting bacteriuria requires urine culture because dipstick alone is insufficient in pregnancy.
Screen And Treat Asymptomatic Bacteriuria
- Screen pregnant women with urine culture at their initial visit and treat asymptomatic bacteriuria when found.
- Use ampicillin or a cephalosporin for 4–7 days rather than single-dose therapy.
Bacteriuria Links To Pyelonephritis And Preterm Birth
- Asymptomatic bacteriuria in pregnancy increases risk of maternal pyelonephritis and preterm delivery.
- Treating bacteriuria reduces pyelonephritis, preterm birth, and low birth weight.
