For asymptomatic bacteriuria in pregnancy, which screening strategy is recommended?

• A. Urine culture for pregnant women at 12-16 weeks gestation or at the first prenatal visit if later
• B. Urine culture for all adults
• C. Urine dipstick screening for asymptomatic individuals
• D. No screening unless symptoms develop

Answer: (A)

In pregnancy, asymptomatic bacteriuria should be detected with a urine culture during pregnancy, because bacteria in the urine without symptoms can still ascend and cause pyelonephritis and other obstetric complications. The best approach is to screen with a urine culture at 12–16 weeks of gestation, or at the first prenatal visit if the patient presents later in pregnancy. This timing allows early identification and treatment with pregnancy-safe antibiotics to reduce risks for both mother and baby. Urine culture is preferred over dipstick screening, which can miss infections or give false results, and targeted screening of all adults is not recommended because the goal here is maternal-fetal health, not general population screening. If no symptoms develop, screening remains important because treating asymptomatic bacteriuria lowers the chance of progression to symptomatic infection later in pregnancy.