Indicated vs. routine prenatal urine chemical reagent strip testing

J Reprod Med. 2007 Mar;52(3):214-9.

Abstract

Objective: To determine if urinary tract infection, high blood pressure and gestational diabetes mellitus (GDM) are underdiagnosed when prenatal urine testing is done on a clinically indicated vs. routine basis.

Study design: Prenatal and delivery records of 2,981 subjects were reviewed in a predominantly Hispanic and medically underserved population. Patients prior to August 2002 received routine urine screening. After August 2002, women were tested only if preestablished criteria were present.

Results: The number of patients diagnosed with high blood pressure and urinary tract infection was equivalent in the 2 groups. Despite unchanged screening for GDM between groups, the incidence of GDM declined from 9.3% to 4.2%.

Conclusion: GDM, high blood pressure and urinary tract infection will not be underdiagnosed if prenatal urine testing is done on an indicated basis. It is safe to discontinue routine urine screening when a regimen of initial urine cultures, GDM screening at 24-28 weeks, indicated urine chemical reagent strip testing and routine blood pressure determination is used. Criteria for indicated urine testing should be clearly defined and consistently followed by all staff.

MeSH terms

  • Adult
  • Cohort Studies
  • Colorado / epidemiology
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / urine
  • Female
  • Hispanic Americans*
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / epidemiology
  • Hypertension / urine
  • Mass Screening
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / urine
  • Pregnancy Trimester, Second
  • Prenatal Care / methods
  • Prenatal Care / standards
  • Prenatal Diagnosis / methods
  • Reagent Strips
  • Retrospective Studies
  • Risk Factors
  • Urinalysis / methods*
  • Urinary Tract Infections / diagnosis*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / urine

Substances

  • Reagent Strips