Urinary Tract Infections and Their Role in Disseminated Intravascular Coagulation and Miscarriages: A Narrative Review with Special Focus on Pakistan.

A Narrative Review

Abstract

Objective: To review the available evidence regarding the association between urinary tract infections (UTIs), disseminated intravascular coagulation (DIC), and miscarriage, with special emphasis on the burden, antimicrobial resistance patterns, and maternal health implications in Pakistan.

Methods: A narrative review was conducted using PubMed, Scopus, Google Scholar, PakMediNet, and relevant organizational reports. Literature published in English up to 2025 was screened using predefined keywords related to UTIs, pregnancy, maternal sepsis, DIC, miscarriage, and Pakistan. Relevant original studies, systematic reviews, clinical guidelines, and case reports were included.

Results: UTIs are among the most common bacterial infections during pregnancy and are associated with increased risks of pyelonephritis, maternal sepsis, miscarriage, preterm birth, and adverse neonatal outcomes. Progression to severe infection may trigger systemic inflammatory responses leading to DIC. Pakistani studies report a high prevalence of bacteriuria and increasing antimicrobial resistance among uropathogens, particularly Escherichia coli. Delayed diagnosis and inadequate treatment contribute substantially to maternal morbidity and pregnancy loss.

Conclusion: UTIs in pregnancy represent a significant but preventable contributor to maternal and fetal complications. Early screening, appropriate antimicrobial therapy, antimicrobial stewardship, and prompt recognition of maternal sepsis are essential to reduce the risks of DIC, miscarriage, and maternal mortality in Pakistan.