URINARY TRACK INFECTION IN PREGNANCY (UTI in Pregnancy)

By Brad S. Bootstaylor, MD, FACOG

Although UTI in pregnancy is a common complication, the treatment is relatively simple and effective (e.g. Antibiotic medication). Unfortunately if untreated, the UTI can progress to pyelonephritis (infection of the kidney), and significantly increase the patient’s risk for preterm delivery, and maternal morbidity. Oftentimes, the symptoms of UTI are confound with benign discomfort experienced in pregnancy. Allowing the patient become aware of the various signs and symptoms of UTI in pregnancy can therefore, help to reduce complications and improve the outcome of her pregnancy.

Basic Information

Description - Urinary tract infections (UTIs) can involve the bladder, kidneys, ureters (tubes connecting kidneys to bladder) and urethra (vessel that leads from bladder to external opening through which urination occurs). Pregnant women have a greater risk of developing urinary tract infections.

Disorders include:

  • Asymptomatic bacteriuria (presence of multiplying bacteria in the urinary tract without obvious symptoms).
  • Cystitis, which is an infection of the urinary bladder.
  • Pyelonephritis, which is a kidney infection that can arise from cystitis. It is a significant and potentially dangerous infection.

FREQUENT SIGNS & SYMPTOMS

  • Sometimes, no symptoms are obvious.
  • Burning sensation during urination.
  • Feeling the urge to urinate when the bladder is practically empty.
  • A nagging type pain in the lower abdomen.
  • Cloudy and unpleasant-smelling urine.
  • With pyelonephritis, there may be fever, chills, nausea, omitting and flank pain.

CAUSES - A breakdown in the body’s defense mechanisms that allows bacteria from the vagina, perineum, rectum, or a sexual partner to invade the urinary tract system. Women are more vulnerable to these infections due to shortness of the urethra. Infection ascends from the urethra to the bladder. Various changes in the urinary tract in pregnant women increase the risk of infection.

RISK INCREASES WITH A history of urinary tract infections. Diabetes mellitus. Sickle cell anemia trait. Underlying abnormalities of the urinary tract. More than 3 previous pregnancies. Presence of renal stones (nephrolithiasis)

PREVENTIVE MEASURES

  • Drinking plenty of fluid (8 glasses of water a day).
  • Empty bladder immediately before and right after sexual intercourse.
  • Wipe from front to back after a bowel movement.
  • Urine studies during prenatal office visits.
  • Don’t postpone urination

EXPECTED OUTCOME - With early diagnosis and treatment, symptoms usually resolve in a few days. Recurrence is not uncommon.

POSSIBLE COMPLICATIONS - Pyelonephritis, that may become chronic. Untreated urinary tract infections that can progress to pyelonephritis, which is associated with premature labor and poses a serious risk to the unborn child and mother.

TREATMENT - General Measures

Diagnostic laboratory tests will include a urinalysis and urine culture. You will be advised on how to collect a clean, midstream urine sample. For an asymptomatic (no apparent symptoms) infection or cystitis, medication is generally all that is required for treatment. Follow-up urine cultures are important to ensure that the infection is eradicated.

Pyelonephritis treatment normally requires hospitalization for intravenous medications and careful monitoring for complications, such as dehydration. If there is no improvement in symptoms, further diagnostic testing is considered.

Medication - Antibiotics will be prescribed. It is important to complete the full dosage even if the symptoms disappear. In some cases, when a UTI recurs, antibiotic treatment may be recommended for the remainder of the pregnancy. In cases of pyelonephritis, antibiotic therapy is often continued to suppress future infections, a preventive strategy referred to as antibiotic prophylaxis.

Activity - No restrictions Avoid sexual intercourse when symptoms are present

Diet - No special diet. Drink plenty of fluids (especially water).

Brad Bootstaylor, MD, FACOG.
404-223-9306
550 Peachtree Street Suite 1165 Atlanta, GA 30308
www.seebaby.org

 

 
 
 
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