Authored By: Dr. K. Shilpi Reddy

HOD & Sr. Consultant Obstetrician & Gynaecologist,

High-Risk Pregnancy Care, Minimal Invasive Surgeon (Mini Lap, Laparoscopy, Robotic Team)


urinary tract infection (UTI) is an infection of a part of your urinary system, which includes your:

Bacteria cause most UTIs. It can affect anyone, but they’re most common in women, and it can me more frequent if you’re pregnant.

Why are UTIs common during pregnancy?

UTIs are common during pregnancy as the growing fetus can put pressure on the bladder and urinary tract. This traps bacteria or causes urine to leak.

There are also physical changes to consider. As early as six weeks of pregnancy, almost all pregnant women experience ureteral dilation, when the urethra expands and continues to expand until delivery.

The increased size of urinary tract, along with increased bladder volume and decreased bladder tone, all cause the urine to become more still in the urethra. This allows bacteria to grow.

To make matters worse, a pregnant woman’s urine gets more concentrated and it has certain types of hormones and sugar. These encourages bacterial growth and lower your body’s ability to fight off infection.

SYMPTOMS

If you have a UTI, you may have:

  • Urgent need to urinate or urinating more often
  • Trouble with urinating
  • A burning sensation or cramps in your lower back or lower abdomen
  • A burning feeling when you urinate
  • Urine that looks cloudy or has odor
  • Blood in your urine, which can turn it red, bright pink, or cola-colored

Incase of kidney infection, you may have:

  • Fever
  • Nausea
  • Vomiting
  • Upper back pain, mostly on just one side

If you have symptoms of a kidney infection, take treatment immediately as per your Doctor. Without proper treatment, the infection can progress and spread causing life-threatening conditions.

COMPLICATIONS

  • Preterm labor
  • Severe infection
  • Adult respiratory distress syndrome
  • Anemia
  • Long-term infection

PREVENTION

To try to avoid getting a UTI:

  • Drink minimum eight glasses of water a day.
  • Wipe yourself from front to back when you go to the bathroom and not back to front.
  • Empty your bladder before and after sex.
  • If you need a lubricant when you have sex, choose a water-based one.
  • Don’t douche.
  • Avoid feminine deodorants or soaps that cause irritation.
  • Wash your genital area with warm water before sex.
  • Wear cotton underwear.
  • Take showers instead of baths.
  • Don’t wear pants that are too tight.
  • Pee often and don’t hold urine for long hours
  • Avoid alcohol, citrus juices, spicy food, and caffeinated drinks, which can irritate your bladder.

DIAGNOSIS

After detailed history and examination, following tests might be needed depending on severity of infection-

  • Urine microscopy
  • Urine culture & sensitivity
  • Ultrasound pelvis
  • Xray-KUB

TREATMENT

Pregnant women should see their doctor if they have any symptoms of a UTI. Without treatment, a UTI can cause serious complications.

3-7 days course of antibiotics may be necessary to treat a UTI during pregnancy. Following antibiotics can be given only after urine culture & sensitivity-

  • Amoxicillin
  • Ampicillin
  • Cephalosporins
  • Nitrofurantoin
  • Trimethoprim-sulfamethoxazole

Irrational use of antibiotics should be avoided as it leads to multidrug resistant infections in future.

If pregnant women develop a kidney infection during pregnancy, they will need hospitalisation. This treatment will involve antibiotics and intravenous fluids.

Recurrent UTIs might need prolonged Antibiotic Therapy upto 3-4weeks.

A short course of antibiotics does not cause any harm to a developing fetus. Research suggests that the benefits of taking antibiotics to treat a UTI are more than the risks of leaving a UTI without treatment.

  • Drinking plenty of water: Water dilutes urine and helps flush bacteria out of the urinary tract.
  • Drinking cranberry juice: Cranberries contain compounds that may help to stop bacteria from attaching to the lining of the urinary tract. This action helps to prevent and eliminate infection.
  • Urinating when the urge arises: This helps bacteria pass out of the urinary tract more quickly.
  • Taking certain supplements: A 2016 study found that a combination of vitamin Ccranberries, and probiotics may help to treat recurrent UTIs in women.

Vaginal Culture & Sensitivity: Examination to rule out vaginal infection should be done especially in cases of recurrent UTI as it occurs concomitantly.

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