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URINE CYTOLOGY –DIAGNOSING URINARY TRACT INFECTIONS (UTIS) IN PREGNANT WOMEN

Urine Cytology –Diagnosis of Urinary Tract Infections (UTIs) in Pregnant Women


CHAPTER ONE

1.0.                                            INTRODUCTION

1.1     BACKGROUND TO THE STUDY

Urine is one of the specimens frequently required in exfoliative cytology investigation. The problem associated with urine specimen is the method of collection, transport, procession and interpretation of the results obtained bearing in mind that the most common sites of urinary tract infection (UTI) are the bladder (cystitis) and the ureters. Thabane, L.  and  Akl, E.A. (2011).  It is from this sites that infection ascends to the ureters and sometimes involve the kidney. This malady leads to the premature and aberrant shedding of the cells in the affected areas. Urine serves as a flushing fluid that washes these areas, thus when a urine sample is collected properly, it presents a lots as well as these etiologic particles in higher concentrations , T.F. and  Rylander, R. (2010).Females are known to be more prone to UTI than males and also present greater problem in the proper collection of urine specimen for cytological analysis , T.F. and  Rylander, R. (2010). Pregnancy causes numerous changes in the body of the woman. Mechanical and hormonal changes increase the risk of vesicoureteral reflux and urinary stasis. These changes, along with an already short urethra (approximately 3-4 cm in females) and difficulty with hygiene due to a distended pregnant belly, increase the frequency of urinary tract infections (UTIs) in pregnant women. Indeed, UTIs are among the most common bacterial infections during pregnancy. In general, pregnant patients are considered immunocompromised UTI hosts because of the physiologic changes associated with pregnancy. The changes increase the risk of serious infectious complications from symptomatic and asymptomatic urinary infections even in healthy pregnant women.

Urine cytology has become a diagnostic tool for the early detection and diagnosis of malignancy in different organs of the body Keiser, S.D. May, W.L. (2008).  In the assessment of hormonal activity which is valuable in some cases of infertility or in the evaluation of uncertain renal disorders of urine cytology, the microscopic evaluation is based upon observation and the characteristics of the basic cells. Since a majority of cells are in form of single cast of cells in a fluid medium. There is no distortion to their shapes. This is unlike histopatholoy where the arrangement of cells aggregates in the basis of diagnosis of malignancy. Most of the information from the study of discrete cells is based on the shape or size of the nuclei. Cytoplasm of cells may only assist in identifying the cells type (Norby, S.M and Garovic, V.D. 2010).

1.1     AIM AND OBJECTIVES

  1. To demonstrate the cellular details of pregnant women’s urine and demonstrate the peculiarities of pregnant women’s urine samples
  2. To ascertain whether urine cytology be used as an alternatives to more invasive and expensive methods during the follow up and diagnosis of bladder tumors.
  3. To study the cytomorphological pattern of urinary disorders in pregnancy within our geographical setting.
  4. To ascertain the most effective diagnostic techniques of urine cytology
  5. To determine the diagnostic value and accuracy parameter of urine cytology of pregnant women.

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Topic: Urine Cytology –Diagnosis of Urinary Tract Infections (UTIs) in Pregnant Women

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