Asymptomatic bacteriuria in pregnancy should be treated to prevent pyelonephritis; commonly with:

• A. Treated to prevent pyelonephritis
• B. Not treated
• C. Treated with analgesics
• D. Treated only in third trimester

Answer: (A)

Treating asymptomatic bacteriuria in pregnancy is essential to prevent progression to acute pyelonephritis, which can cause serious maternal and fetal complications. Because many infections in pregnancy are silent, screening and treating this bacteriuria reduces the risk of pyelonephritis, preterm birth, low birth weight, and maternal sepsis. The usual approach is to use a pregnancy-safe antibiotic for several days (commonly nitrofurantoin or a beta-lactam like cephalexin or amoxicillin-clavulanate), and then retest with a urine culture to confirm clearance. Not treating would leave the infection in place and allow it to ascend, while analgesics would not eradicate the bacteria, and delaying treatment until the third trimester fails to prevent potential complications earlier in pregnancy.