Which screening test is used to detect urinary tract infections during pregnancy?

Raj. CHO -2025

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2025

Explanation

The urine dipstick test is a rapid, non-invasive, and cost-effective method used for initial screening of UTIs.
It detects key indicators of infection, such as leukocyte esterase (from white blood cells) and nitrites (a byproduct of common urinary pathogens).
A positive dipstick result prompts further investigation with a urine culture, but it serves as the primary screening step.
Early detection through screening is vital in pregnancy to prevent complications from asymptomatic bacteriuria.

Option B: A complete blood count (CBC) indicates a systemic inflammatory response (like an elevated WBC count) but is not specific to the urinary tract. It cannot differentiate a UTI from an infection elsewhere in the body.
Option C: An ultrasound is an imaging modality that assesses the structure of the kidneys and bladder. It does not detect the presence of bacteria or infection itself.
Option D: Cervical cytology (Pap smear) is a screening test for cervical cancer and cellular changes caused by the human papillomavirus (HPV). It has no role in diagnosing urinary tract infections.

Visual 1: Image: A urine dipstick test strip next to its container's color chart, highlighting the sections for 'Leukocytes' and 'Nitrite' to show how results are interpreted.
Visual 2: Infographic: A flowchart showing the screening and diagnostic pathway for UTIs in pregnancy, starting with a routine dipstick test, leading to urine culture if positive, and then to targeted antibiotic therapy.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Screening for Urinary Tract Infections (UTIs) in Pregnancy as background academic context rather than a clinical decision trigger.
Nurses are often responsible for collecting urine samples and performing dipstick tests at antenatal visits. Accurate technique and interpretation are essential for reliable screening.
Patient education is a key nursing role. The nurse must explain the importance of treating UTIs in pregnancy, even if the patient feels well (asymptomatic bacteriuria), to prevent harm to both mother and baby.
What if the dipstick is negative for nitrites but positive for leukocyte esterase? The nurse should still consider it a positive screen and send the urine for culture. Some bacteria do not produce nitrites, and leukocyte esterase alone is a significant finding.

How to Approach the Question

First, identify the key terms in the question: 'screening test', 'urinary tract infections', and 'pregnancy'. The word 'screening' implies a rapid, initial test, not a definitive diagnostic or imaging procedure.
Evaluate each option based on its primary function. Ask yourself, 'What is this test typically used for?'
Consider Option A (Urine dipstick): This is a well-known, quick test for urine abnormalities. It fits the description of a 'screening' tool.
Consider Option B (CBC): This is a blood test for general infection/inflammation, not specific to the urinary tract.
Consider Option C (Ultrasound): This is an imaging test for structure, not a test for infection.
Consider Option D (Cervical cytology): This is for cervical cancer screening, not UTIs.

Concept Tested & Keywords

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