Why Are UTIs More Common During Pregnancy?

Every woman’s body is different, so be sure to tell your doctor about any pain or discomfort you feel promptly — especially if you experience any of these typical UTI symptoms.

-Dr. Sriprada Vinekar, Senior Consultant Obstetrician and Gynaecologist, Cloudnine Group of Hospitals, Bangalore (Malleshwaram)

Pregnancy is a wellness and not an illness. It causes numerous changes in the woman’s body. It can also increase the likelihood of urinary tract infections (UTIs). These changes, along with an already short urethra (approximately 3-4 cm in females) and difficulty with hygiene due to a distended pregnant belly, help make UTIs the most common bacterial infections during pregnancy.

What is a Urinary tract infection (UTI)?

Urinary tract infection (UTI) is an infection of the body’s urinary system, which includes the Kidneys, Ureters, Bladder, or Urethra. They are common, and women can often experience them during pregnancy. Left untreated, a UTI can pose a serious health risk to a pregnant woman and a developing fetus.

Pregnant women are at increased risk for UTIs. Beginning in week 6 and peaking during weeks 22 to 24, approximately 90 percent of pregnant women develop ureteral dilatation, which will remain until delivery.

It is important to understand that during pregnancy, the uterus expands for the growing fetus. This expansion puts pressure on the bladder and the ureters. The ureters are the tubes that carry urine from the kidneys to the bladder. The urine is also less acidic and contains more proteins, sugars, and hormones during pregnancy.

This combination of factors increases the risk of a UTI occurring. Fortunately, UTIs in pregnancy are most often easily treated. Rarely, pregnancies complicated by UTI will lead to significant maternal and fetal morbidity.

Are pregnant women more susceptible to UTI?

Yes. Ureteral dilation is seen due to compression of the ureters from the pregnant uterus.  The growing uterus also presses on the bladder leading to incomplete emptying of the bladder. Leftover urine can be a source of infection. Hormonal effects of progesterone also may cause smooth muscle relaxation leading to dilation and urinary stasis, and vesicoureteral reflux increases.  Pregnancy is a state of relative immunocompromise leading to infection. Bacteria cause most UTIs and hence can be easily treated with antibiotics

Symptoms of UTI in pregnancy

Every woman’s body is different, so be sure to tell your doctor about any pain or discomfort you feel promptly — especially if you experience any of these typical UTI symptoms. Asymptomatic urinary infection occurs in 2 to 7 percent of pregnant women.

Without treatment, as many as 20 to 35 percent of pregnant women with asymptomatic bacteriuria will develop asymptomatic urinary tract infection (UTI) leading to complications. It is recommended that all pregnant women be screened for asymptomatic bacteriuria at the first prenatal visit.

However, the most common symptoms are as follows.

  • An urgent need to pass urine or urinating more often
  • A burning sensation or cramps in your lower back or lower belly
  • A burning feeling while urinating
  • Urine that looks cloudy or has an odor
  • Blood in the urine

In some cases, the bacterial infection causing a UTI can spread to the kidneys and cause the following symptoms

  • Fever, chills
  • Nausea
  • Vomiting
  • Upper back pain

Complications associated with UTI

  • Kidney infection
  • Sepsis
  • Preterm labor leading to premature birth
  • Low Birthweight babies
  • Hypertension in pregnancy
  • Anemia

Treatment

ASB and acute cystitis are treated with antibiotic therapy. Antibiotic choice can be tailored based on organism sensitivities when available from urine culture results.

How to avoid getting a UTI:

  • Drink at least eight glasses of water a day
  • Drink cranberry juice
  • Wipe yourself from front to back when you go to the bathroom.
  • Empty your bladder shortly before and after sex
  • Wear cotton underwear
  • Don’t wear pants that are too tight
  • Urinate often
  • Avoid alcohol, citrus juices, spicy food, and caffeinated drinks, which can irritate your bladder
  • avoiding any harsh soaps or body wash in the genital area

Always remember, routine pregnancy checks help detect the early signs of a UTI.

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