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Over the past 25 years, there has been a dramatic increase in the incidence of asymptomatic bacteriuria. Consequently, the incidence of complications during pregnancy such as pyelonephritis, tubo-ovarian abscess and sepsis has also increased. For this reason, it is necessary to identify bacteriuria during pregnancy. This is done by urinalysis and/or urine culture with the detection of pyuria and bacteriuria (> or = 10(3) cfu/ml of more than two consecutive cultures). This should always be performed in the presence of UTI symptoms or previous history of urinary tract infection. Pyelonephritis has been associated with premature rupture of the membrane, preterm delivery, cord-negative, low birth weight, chorioamnionitis, subnormal levels of fetal arterial umbilical blood gases, renal failure, functional anomalies of the urinary tract, hypertension, pyelonephritis in the mother and death in utero. The evidence of an association between asymptomatic bacteriuria and these disorders is not conclusive. Pyelonephritis during pregnancy may be treated with antibiotics, but the risk of antibiotic side effects and the value of treatment is controversial. The treatment for asymptomatic bacteriuria has not been established. Although guidelines to determine antibiotic treatment for asymptomatic bacteriuria during pregnancy are not available, it is prudent to prescribe antibiotics as an initial approach.Effects of caffeine on alpha-1-adrenergic responsiveness in man.
The alpha-1-adrenergic-mediated increase in forearm blood flow in humans has previously been shown to be inhibited by theophylline, due to the blockade of the alpha-1 receptor. However, caffeine is
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