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Experiencing increased fetal movement. Is it an indication of fetal well-being or distress? Interpretation of urine test?

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Practicing since : 2002
Answered : 2565 Questions
Dear Doc,
I am 41 years old and in the 35th week of pregnancy. Though I had BP even before getting pregnant, my BP was given attention only in 2nd semester and since then I was put on BP medication "Alphadopa", apart from the regular multivitamin (Calcium Forte) and folic acid (Autrin) supplements from first trimester. Also, since my BP wasn't very well controlled and I had swelling on my ankles, Alphadopa was doubled in dosage since last 4 weeks. Additionally, last few days (from about 10+ days) I have been experiencing increase in fetal movement like it is crammed for space. Could this be an indication of fetal wellbeing or distress?
My Urine routine and culture reports taken during the 34th-35th week are as follows - Please help interpret...and what to expect ?!

Urine Routine and Microscopy:
Color: Pale Yellow
Appearance: S. Turbid
Albumin (Urine): Trace
Specific Gravity: 1.005
PH: 6.5
Sugar: Nil
Pus Cells: 18-20 /hpf
Epithelial Cells: 8-10 /hpf
RBCs: Nil
Bacteria: Present (+)

Urine Culture Sensitivity Report:
Organisms isolated: Primary Smear report: Few cells with Gram Negative Bacilli are seen.
Culture Report: Escherichia isolated in culture on aerobic incubation. Colony count: 1,00,000 CFU/ml of urine.

Sensitivity Pattern      Observation      Interpretation
Aztreonam          24          S
Ampicillin/Sulbactum     00          R
Amikacin               00          R
Ceftazidime          00          R
Co-Trimoxazole          22          S
Cefadroxyl          00          R
Imipenem               20          S
Cefepime               00          R
Gentamicin          16          S
Amoxyclav          00          R
Cefotaxime          00          R
Cefixime               00          R
Cephoxitin          00          R
Ciprofloxacin          22          S
Gatifloxacin          23          S
Meropenum          20          S
Netilmycin          18          S
Ofloxacin               00          R
Nitrofurantoin          17          S
Piperacillin/Tazobactum     00          R     

Culture indicates “Significant Bacteriuria”
Posted Sun, 6 May 2012 in Pregnancy
Answered by Dr. Robert Galamaga 59 minutes later
Hello and thanks for the question.

First of all I do not think your baby is in distress. This is just part of the normal process of pregnancy as the baby grows more and more movement will be appreciated by you. This is especially true during the last few weeks of pregnancy.

As for the urinalysis this does indicate that you have a urinary infection. Your doctor will decide how to treat this and it looks from the culture report like nitrofurantoin might be a good antibiotic choice and I believe it is safe this far along in the pregnancy. I am not sure if your doctor has discussed this with you. Sometimes the obstetrician may prefer to wait until delivery to give antibiotics. I encourage you to discuss this with him.

Thanks again for the query. I hope you have found my response to be helpful. If you have any additional concerns I would be happy to address them.


Dr. Galamaga
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