Managing Complications in Pregnancy and Childbirth: - IAWG

S-102 Fever during pregnancy and labour• Microscopy of urine specimen may show white cells in clumps,bacteria and sometimes red cells.• Urine culture and sensitivity tests should be done, if available, toidentify the organism and its antibiotic sensitivity.Note: Urine examination requires a clean-catch mid-stream specimen tominimize the possibility of contamination.CYSTITISCystitis is infection of the bladder.• Treat with antibiotics (page C-35):- amoxicillin 500 mg by mouth three times per day for 3 days;- OR trimethoprim/sulfamethoxazole 1 tablet (160/800 mg) bymouth two times per day for 3 days.• If treatment fails, check urine culture and sensitivity, if available,and treat with an antibiotic appropriate for the organism.• If infection recurs two or more times:- Check urine culture and sensitivity, if available, and treat withan antibiotic appropriate for the organism;- For prophylaxis against further infections, give antibiotics bymouth once daily at bedtime for the remainder of pregnancyand 2 weeks postpartum. Give:- trimethoprim/sulfamethoxazole 1 tablet (160/800 mg);- OR amoxicillin 250 mg.Note: Prophylaxis is indicated after recurrent infections, notafter a single episode.ACUTE PYELONEPHRITISAcute pyelonephritis is an acute infection of the upper urinary tract,mainly of the renal pelvis, which may also involve renal parenchyma.• If shock is present or suspected, initiate immediate treatment (pageS-1).• Check urine culture and sensitivity, if possible, and treat with anantibiotic appropriate for the organism.