| 42 | Nitrites | 1 = yes, 2 = no |
| 43 | Culture done |
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| 44 | If yes culture results | 1 = Normal urine 2 = Urinary infection |
| 45 | Number of colony unit | 1 = >105, 2 = <105 |
| 46 | If urinary infection during culture precise the germs: -E. coli |
1 = yes, 2 = no |
| 47 | -Proteus mirabilis | 1 = yes, 2 = no |
| 48 | -Enterobacter | 1 = yes, 2 = no |
| 49 | -Other microorganisms | 1 = yes, 2 = no |
| 50 | If other microorganisms (precise) |
|
|
| Section IV: Maternal Outcomes |
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| 51 | Pyelonephritis | 1 = yes, 2 = no |
| 52 | Amnionites | 1 = yes, 2 = no |
| 53 | Recurrent urinary tract infection during same pregnancy | 1 = yes, 2 = no |
| 54 | Threatened abortion | 1 = yes, 2 = no |
| 55 | Threatened preterm labor | 1 = yes, 2 = no |
| 56 | Premature of rupture of fetal membranes | 1 = yes, 2 = no |
| 57 | Genital infection | 1 = yes, 2 = no |
| 58 | Delivery method | 1 = NVD, 2 = Cesarean section |
| 59 | Gestational age at delivery |
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|
| Fetal Outcomes |
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| 60 | Birth Weight of the baby (grams) | 1st baby = 2nd baby = 3rd baby = |
| 61 | Apgar Score |
|
| 62 | Sex | 1 = male, 2 = female |
| 63 | Neonatal infection | 1 = yes, 2 = no |
| 64 | Neonatal jaundice | 1 = yes, 2 = no |
| 65 | Neonatal intensive unit admission | 1 = yes, 2 = no |