title: [Antibioprophylaxy and urological management of women with spinal cord injury during pregnancy].
abstract: OBJECTIVE
  More and more women with spinal cord injury (SCI) can have a pregnancy. Few data have been published on these pregnancies and their urological impact. We report a series of these cases illustrating the urological experience of specialized centers.
  
  
  METHODS
  This is a retrospective study that identified pregnancies in women with SCI followed-up between 2000 and 2014. Data covering all urological and obstetric events during pregnancies, before and after implementation of weekly oral cyclic antibiotics (WOCA) program, were collected from medical records.
  
  
  RESULTS
  Fifteen women with SCI who gave birth to 20 children were included. Three of them were quadriplegics and 12 were paraplegics. All of them performed themselves intermittent catheterization: 11 by urethral way and 4 by high way because carrying a continent cystostomy. Mean follow-up period before pregnancy was 14.6 years [3-27 years IC 95%] and the mean follow-up for the study was 8.5 months [6.5-9 IC 95%]. We observed a reduction of symptomatic urinary tract infections after WOCA onset (13/13 before vs. 0/7 after, P=0.001), a reduction of recurrent urinary infections (6/13 vs. 0/7, P=0.03), a reduction of threats to premature births (8/13 vs. 0/7, P=0.001). Multi-resistant bacteria appeared to increase (0/13 vs. 3/7, P=0.01). We also observed a trend to significant reduction of premature births number (4/13 vs. 0/13, P=0.1) and that of low birth weight (3/13 versus 0/7, P=0.1). The overall neonatal survival rate was 100%.
  
  
  CONCLUSIONS
  Our study before/after introduction of a weekly oral cycle antibiotic prophylaxis during pregnancy for women with spinal cord injury showed a significant reduction in symptomatic urinary tract infections and a tendency to improve pregnancy outcomes.
  
  
  METHODS
  4.
authors: Service d'urologie, CHU de Saint-Étienne, avenue Albert-Raimond, 42055 Saint-Étienne, France; Service de rééducation neuropérinéale et sexologique, hôpital Henry-Gabrielle, hospices civils de Lyon, 69230 Saint-Genis-Laval, France. Electronic address: nargisse.talji@etu.univ-st-etienne.fr.
authors: N
authors: N
authors: Galusca
authors: Service de rééducation neuropérinéale et sexologique, hôpital Henry-Gabrielle, hospices civils de Lyon, 69230 Saint-Genis-Laval, France.
authors: K
authors: K
authors: Charvier
authors: Department of sexology, université du Québec, CP 8888 succursale centre-ville, H3C 3P8 Montreal, Quebec, Canada.
authors: F
authors: F
authors: Courtois
authors: Service de médecine physique et réadaptation, hôpital Henry-Gabrielle, 69230 Saint-Genis-Laval, France.
authors: G
authors: G
authors: Rode
authors: Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande-Rue de la Croix-Rousse, 69317 Lyon cedex 4, France.
authors: R C
authors: RC
authors: Rudigoz
authors: Service d'urologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France.
authors: A
authors: A
authors: Ruffion
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000209:etiology* / Q000517:prevention & control*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D014552:Urinary Tract Infections / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Femme; Grossesse; Infection urinaire; Lésion médullaire; Neurogenic bladder; Pregnancy; Spinal cord injury; Urinary tract infection; Vessie neurologique; Woman