Are Utis A Risk During Pregnancy
During pregnancy, many changes occur in your body that increase your risk of developing a UTI, including changes to the make-up of your urine and immune system. As your baby grows, there is also an increase in the pressure on your bladder, which can reduce the flow of your urine and lead to an infection.
UTIs can affect women whether they are pregnant or not. However, pregnant women are more likely to develop repeated or more severe infections. Up to 1 in 10 pregnant women will have a UTI but not have any symptoms at all.
What Do My Results Mean
- Asymptomatic bacteriuria: Where you have no symptoms and bacteria are found in your urine.
- Cystitis or UTI: Where bacteria are found in your urine and you have lower urinary tract symptoms.
- Pyelonephritis: If you have the above symptoms, and also have symptoms or signs of fever or feeling unwell, this may indicate upper urinary tract infection such as pyelonephritis.
Your doctor will discuss your results and the appropriate treatment for your situation with you.
Prevention Of Uti During Pregnancy
Although there is very little scientific evidence to support behavioural recommendations around UTI prevention, some people find the following helpful:
- Always wipe front to back after urinating
- Urinate as soon as possible after having intercourse
- Wear cotton underwear and avoid thong underwear
- Do not use douches, scented feminine hygiene products, toilet paper or bath additives
- Eat a healthy, whole foods diet with lots of fruits and vegetables
- Take probiotics or eat foods high in probiotics
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Uti Symptoms And Prevention
A urinary tract infection , also called bladder infection, is a bacterial inflammation in the urinary tract. Pregnant women are at increased risk for UTIs starting in week 6 through week 24 because of changes in the urinary tract. The uterus sits directly on top of the bladder. As the uterus grows, its increased weight can block the drainage of urine from the bladder, causing a urinary tract infection during pregnancy.
Deterrence And Patient Education
After 2 to 4 weeks following completion of treatment, urine culture should be obtained to assure that reinfection has not occurred.
Suppressive antibiotic therapy, usually with nitrofurantoin once daily, is commonly recommended especially in cases where patients have had prior UTI. This is typically continued thru pregnancy and the early postpartum period.
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How To Prevent A Uti
One way to avoid the use of antibiotics is by preventing the development of an infection in the first place. There are a number a key steps you can take to prevent a urinary tract infection while you are pregnant 4:
- Try as best you can to fully empty your bladder when you pee, to ensure that bacteria doesnt hang around in the urinary tract
- Keep hydrated so that any harmful bacteria are flushed out of your system
- Dont wear clothing that is too tight – wear looser, more breathable clothing including cotton underwear
- Keep the area clean and dry, and avoid the use of soaps, vaginal lotions or bubble bath products. These can affect the functioning of good bacteria which is needed to counteract the bad
- Eat a healthy, balanced diet. Ingesting plenty of vitamins and minerals will help to balance your microbiome, and also prevent constipation, another risk factor for UTI.
For more information on general prevention strategies visit our UTI prevention blog, and for more tips on preventing cystitis with dietary changes, check out our Nutrition and Hydration blog.
When Should You Test For Uti
Experiencing a UTI at any time over the course of your life increases the risk of another UTI, including during pregnancy.
If you have had UTIs in the past, have frequent urination, or have been diagnosed with Interstitial Cystitis or chronic bladder pain, you may have bacteria in your bladder that can cause infection.
|Many of my patients find that the nagging irritation they have in the bladder is really an infection, even after multiple negative urinalysis and cultures. It is important to identify these infections prior to conception.|
As a UTI can lead to infertility, and in pregnancy can lead to serious complications, it is important to determine whether an infection is present, prior to conception.
Females with fertility issues may benefit from a urine test, while males with fertility issues may benefit from testing both the urine and semen.
There are specialized labs that can look more deeply at the bladder and vaginal bacteria to determine whether there are bacteria in the urine that should not be there.
Bear in mind though, that a negative dipstick and/or urine culture does not rule out a bacterial infection in the bladder.
If white blood cells are indicated on a dipstick, it is especially important to complete a urine test through a specialized laboratory. This is because the WBCs may indicate an infection that a dipstick or standard urine culture cannot detect.
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When Is My Urine Checked During Pregnancy
- You should usually have your urine tested early in pregnancy. Your midwife may ask you to bring a sample in a container or sample bottle. Treatment is advised if any germs are found – even if you have no symptoms. If bacteria are found, you should have regular routine urine tests throughout the pregnancy.
- You will normally be asked to bring a urine sample at each of your antenatal checks. How often this is depends on how your pregnancy is progressing and whether you have any problems or complications.
- You should also have your urine tested if you develop symptoms of bladder infection or kidney infection at any stage during pregnancy.
What Should I Do If I Suspect A False Negative Pregnancy Test
If your first test is negative and you still think you might be pregnant, your best option is to wait a few days before taking another test. HCG levels double rapidly, so the odds of a positive test just two days after a negative test are very high.
If you cant stand waiting, consider retesting later in the day with a more sensitive test. Home pregnancy tests usually reveal information about their sensitivity on the label, so read labels carefully and choose accordingly.
If you still get a negative test and dont get your period, or if you just cant stand waiting any longer, call your doctor.
A blood test in a doctors office can detect even the lowest levels of HCG. This can be helpful to determine whether your HCG levels are normal. This is an important piece of the puzzle to measure fertility.
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What Are The Common Causes Of Utis
Your urinary tract is normally free of bacteria. If bacteria enter the tract and multiply, they can cause a UTI. There are several factors that increase the risk of developing an infection:
- Infection with common bacteria in your gut, usually from faeces can contaminate your urinary tract
- Being sexually active increases the risk of bacteria moving around the genital area and entering the urinary tract
- If you have weak pelvic floor muscles your bladder might not empty completely, which can lead to an infection
- Women with diabetes are at increased risk of developing a UTI since the sugar in their urine may cause bacteria to multiply
Complications Caused By Uti During Pregnancy
The presence of a UTI can increase the chances of complications during pregnancy, labor and delivery.
During pregnancy, the risks of untreated UTI include kidney infection, fetal growth restriction, preeclampsia and preterm birth.
Earlier, I briefly mentioned asymptomatic bacteriuria. This is a situation where there are no symptoms of a UTI, but a significant level of bacteria in the urine is present.
This is seen in about 10% of pregnancies. For this reason, there is generally a screening for asymptomatic bacteriuria at the first prenatal visit and again between 12 and 16 weeks.
Asymptomatic bacteriuria will be treated the same way a UTI is treated. When asymptomatic bacteriuria goes untreated in pregnancy, approximately 30% of patients will develop a symptomatic UTI. Up to 50% will develop a kidney infection.
Kidney infection in pregnancy is the leading cause of preterm labor, putting the baby at risk for serious complications and even death.
If a UTI is present during delivery, bacteria can get into the babys eyes, nose or mouth as they pass through the birth canal, causing infection.
The babys immune system is still developing at the time of delivery. A relatively harmless infection such as E. coli, the most common cause of UTIs, can be life-threatening in a newborn.
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What Are The Signs And Symptoms Of Utis
If you have a urinary tract infection, you may experience one or more of the following symptoms:
- Pain or burning when urinating
- The need to urinate more often than usual
- A feeling of urgency when you urinate
- Blood or mucus in the urine
- Cramps or pain in the lower abdomen
- Pain during sexual intercourse
- Chills, fever, sweats, leaking of urine
- Waking up from sleep to urinate
- Change in the amount of urine, either more or less
- Urine that looks cloudy, smells foul or unusually strong
- Pain, pressure, or tenderness in the area of the bladder
- When bacteria spreads to the kidneys you may experience back pain, chills, fever, nausea, and vomiting.
Medications For The Treatment Of Urinary Tract Infection During Pregnancy
Antibiotic medications are frequently used to treat urinary tract infections in women who are pregnant. They are typically prescribed for three to 10 days, depending on the type of medication and the severity of the infection. Common antibiotics that have been approved for the treatment of urinary tract infections during pregnancy include:
- Penicillins: Penicillins, including amoxicillin, were once the principle treatment of choice for urinary tract infections, but are ineffective against E. coli-driven UTIs in up to 30 percent of cases. They are, however, useful against urinary tract infections caused by other bacteria, such as Staphylococcus saprophyticus or Enterococcus. Stubborn, drug-resistant infections may have to be addressed with Augmentin . Penicillins are typically prescribed for 10 days and are generally well tolerated by most patients. Side effects include diarrhea, nausea, stomach pain, and vaginal itching or discharge.
- Cephalosporins: Cephalosporins include medications such as cephalexin , cefuroxime and cefadrozil . These antibiotics are currently the most widely prescribed medications for UTIs, but can only be used in the first and second trimesters. Because of their potency, cephalosporins are usually prescribed for three to seven days and are well tolerated. Side effects of these medications include upset stomach, nausea, vomiting, and diarrhea.
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Uti Treatment: What To Expect
UTI treatments during pregnancy are safe and easy, usually involving a short course of oral antibiotics. There are two exceptions:
- If you continue to have UTIs after we treat the first one, we may recommend suppressive therapy. You will take a lower dose of antibiotics every day of your pregnancy instead of larger doses for just a few days.
- If you have pyelonephritis , you will need to receive antibiotics through an IV at a hospital.
For most patients, receiving antibiotic treatment is much safer than risking a kidney infection. We will discuss all your health conditions and pregnancy symptoms to determine the best type of antibiotic for you, depending on what will work effectively against the bacteria in your urine.
Uti Symptoms In Pregnancy
The most common symptoms of a UTI are pain or burning when you pee and the urgent need to pee frequently. The burning feeling is caused by urine passing through an inflamed urethra. The need to race to the bathroom every few minutes is caused by inflammation in the wall of the bladder. When the bladder is infected and irritated, holding even a small amount of urine can feel uncomfortable.
When youre pregnant, the pressure of your uterus on your bladder can make it feel like you need to go to the bathroom frequently. This is normal. It may be inconvenient, but it shouldnt feel like you need to go urgently every few minutes. Also, passing your urine shouldnt hurt. Signs of infection include the painful need to urinate immediately only to discover there is very little urine in your bladder along with pain while the urine is coming.
If you get a fever or back pain with a UTI, that could mean the infection has progressed beyond your bladder to your kidneys. This is called pyelonephritis. It is a much more serious infection that can result in long-term problems for you and your baby. For this reason, if you have a UTI and a fever during pregnancy, you should always be seen by a medical professional right away.
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Uti Causes Symptoms And Treatment Options During Pregnancy
While over half of women will experience a UTI at some point in their lifetime, UTI affects approximately 8% of women who are pregnant. 1
Asymptomatic bacteriuria is also very common in pregnancy. This is when there are bacteria in your urinary tract but you are not actually experiencing any symptoms or signs of a UTI.
But why is the risk of UTI higher during pregnancy? How do you tell the difference between cystitis symptoms and pregnancy symptoms? And is it safe to be using antibiotics?
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Prepare For Possible Postpartum Utis
In some cases, the risks of developing a UTI increase after you give birth.
Patients who have a C-section or receive an epidural during labor have a catheter inserted into their bladder. This ensures a safer delivery by keeping your bladder empty. But a catheter increases your risk of infection the longer it stays in your body, and its placement provides the perfect track for bacteria to enter your bladder.
To decrease your UTI risk, our goal is to remove your catheter no more than six to eight hours after surgery and even sooner after an epidural. An infection can take days to appear, so watch for symptoms after you leave the hospital and tell your doctor right away if you experience them. We dont perform routine UTI tests after delivery, so its important to alert us to abnormal pain or discomfort.
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With so many new tasks to complete and emotions to experience after bringing your newborn home, it can feel overwhelming to keep track of one more thing but your health remains a priority after the birth of your baby. The more you tell us about how you feel, the more we can do to help you stay healthy.
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How Can I Prevent A Bladder Infection
You may do everything right and still experience a urinary tract infection during pregnancy, but you can reduce the likelihood by doing the following:
- Drink 6-8 glasses of water each day and unsweetened cranberry juice regularly.
- Eliminate refined foods, fruit juices, caffeine, alcohol, and sugar.
- Take Vitamin C , Beta-carotene and Zinc to help fight infection.
- Develop a habit of urinating as soon as the need is felt and empty your bladder completely when you urinate.
- Urinate before and after intercourse.
- Avoid intercourse while you are being treated for a UTI.
- After urinating, blot dry , and keep your genital area clean. Make sure you wipe from the front toward the back.
- Avoid using strong soaps, douches, antiseptic creams, feminine hygiene sprays, and powders.
- Change underwear and pantyhose every day.
- Avoid wearing tight-fitting pants.
- Wear all-cotton or cotton-crotch underwear and pantyhose.
- Dont soak in the bathtub longer than 30 minutes or more than twice a day.
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How Are Utis In Pregnancy Diagnosed
UTIs are diagnosed by doing a urine culture test that looks for bacteria, red cells and white cells in your urine . This is usually done in the first trimester and is different to the urine test to see if you are pregnant.
Your doctor will send a sample of your urine to the laboratory to be tested. If bacteria are found in the urine, the sample will be cultured and tested for antibiotic sensitivities to check which antibiotics will work best.
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What Is The Treatment For Utis In Pregnancy
UTIs in pregnancy are treated with antibiotics, even if you have no symptoms. If left untreated, UTIs can progress to cause a serious kidney infection known as pyelonephritis. They have also been linked with higher rates of low birth weight of the baby and premature birth .
|When you see a health provider, always tell them you are pregnant as not all antibiotics or medicines are safe in pregnancy.|
- Your doctor will choose an antibiotic that is safe to use during your stage of pregnancy. The most commonly recommended antibiotic is nitrofurantoin. Usually, a 7-day course of antibiotics is prescribed. You should finish the whole course to completely treat the infection and reduce the chance of it coming back.
- Your symptoms should begin to improve within a few days, if you had any. If you still have symptoms for more than 2 days after starting treatment, or you get worse, see your doctor as soon as possible.
- After finishing the antibiotics, you will need a further urine check 1 week later to check the infection has been treated properly.
- You will then have urine tests each month while pregnant to make sure the UTI doesn’t come back.
What Increases Or Reduces Risk Of Utis During Pregnancy
Women who have or carry the trait for sickle cell disease are at increased risk for UTIs. We test these patients monthly to ensure we detect an infection as soon as possible.
If you have diabetes, youre also at a higher risk. We might not test you as frequently, but we will consistently look for symptoms. Both conditions make it harder for the body to fight infections.
Just as when youre not pregnant, you can take specific actions to lower your chances of getting a UTI, such as:
- Wiping front to back in the bathroom
- Urinating before and after sex
- Wearing cotton underwear
- Avoiding tight and wet clothing
- Drinking more water
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