Uti Diagnosis And Treatment
Think you may have a UTI? The standard way to diagnose one is a urine culture. Most doctors will ask for a clean catch sample, where you pee into a cup midstream after carefully wiping your outer vaginal area.
If you are diagnosed with a UTI, your doctor will likely provide a pregnancy-safe antibiotic for seven to 14 days to get rid of all of the bacteria. Be sure to take the recommended full course, even if you start to feel better midway through treatment, and drink plenty of water.
If the infection has reached your kidneys, your practitioner may suggest staying in the hospital, where you can receive IV antibiotics.
Keep in mind: Some women have a UTI with no symptoms at all. Because an untreated infection can lead to complications including kidney infection and, potentially, an increased risk of fetal growth restriction, preeclampsia and preterm birth notify your provider immediately if you have any UTI-like symptoms.
Likewise, the urine tests at your regular prenatal visits are really important.
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
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.
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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
Is Ciprofloxacin Safe In Pregnancy
While there are no controlled studies of ciprofloxacin use in pregnant women to show safety, an expert review of published data on experiences with ciprofloxacin use during pregnancy by TERIS the Teratogen Information System concluded that therapeutic doses during pregnancy are unlikely to pose a substantial
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Treating Urinary Tract Infections
Urinary tract infections are fairly common during pregnancy. Research shows that up to 10 percent of expectant moms will get a urinary tract infection at some point during their pregnancy.
Thw relaxed muscles of the tubes that connect the bladder and kidneys and enlarged womb slow down the flow of urine.
This enables the bacteria to enter at the opening of the urethra and travel up to the bladder, where they attach and multiply quickly.
The bacteria Escherichia coli causes the majority of UTIs . This type of bacteria is commonly found in the gastrointestinal tract, normally residing in the large intestine.
Located in the mucous of the urinary tract, Escherichia coli causes inflammation, lower abdominal pain, urinary urgency, burning during urination, mild fever and other discomforts.
Early diagnosis and proper treatment are very important because, if left untreated, the infection may spread and cause miscarriage, premature birth or intrauterine growth restriction.
Herbal tea for relieving urinary tract infections
- chamomile 10 g
Add two tablespoons of tea to a litre of cold water. When the water boils, let it simmer for a minute and then remove. Leave it covered for 5-10 minutes, filter and drink in the course of the day.
Herbal tea contents and the amount of liquid may vary depending on the patient’s condition, age, diagnosis and symptoms.
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.
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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.
Uti Testing In Pregnancy
The standard test for a UTI is a urine culture. This is done by watching a urine sample for several days and measuring the growth of bacteria. Normally, urine is sterile, which means no bacteria should grow. If bacteria do grow, laboratory specialists can do more testing to determine what kind of bacteria they are.
A urinalysis is a faster urine test. For this test, urine is studied under a microscope and checked for signs of infection. The result of a urinalysis can point to a UTI, but it cant determine what kind of bacteria are causing it.
Most providers offices also do a dipstick or spot test of urine samples. These rapid tests are helpful because they are done in just a few minutes and can show signs of infection when a UTI is present. The downside of rapid urine tests is that they provide much less information than either a urinalysis or a urine culture.
Urine tests for infection are not the same tests that are done to check for pregnancy. Having a UTI does not affect a pregnancy test result and vice versa.
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Is It Safe To Take Antibiotics During Pregnancy
Generally speaking, antibiotics are considered safe.”Antibiotics are effective for many common infections and can be used during pregnancy,” confirms Dr. Salinger. Moreover, research suggests that around one in four pregnant women will be prescribed an antibiotic during pregnancy, which accounts for nearly 80 percent of prescription medications for pregnant women.
Dr. Salinger explains that medications, including antibiotics, are grouped into risk categories to help determine whether they are safe to take during pregnancy. They are grouped into the following categories:
- Category A and B: Medications considered safe for pregnant people
- Category C: Medications considered generally safe but should only be used if necessary, as there are risks
- Category D: Medications known to cause potential harm, but may be taken if the benefit is greater than the risk of harm
- Category X: Medications that should not be used during pregnancy
Study Strengths And Weaknesses
The National Birth Defects Prevention Study by Crider and colleagues was a large, well-funded, and well-designed epidemiologic study. It included more than 13,000 patients from 10 different states.
Nevertheless, the study had certain limitations.4 The findings are subject to recall bias because the investigators questioned patients about antibiotic use after, rather than during, pregnancy. Understandably, the investigators were not able to verify the prescriptions for antibiotics by reviewing each individual medical record. In fact, one-third of study participants were unable to recall the exact name of the antibiotic they received. The authors did not precisely distinguish between single-agent sulfonamides and the combination drug, trimethoprim-sulfamethoxazole, although it seems reasonable to assume that the majority of the prescriptions were for the latter. Finally, given the observational nature of the study, the authors could not be certain that the observed associations were due to the antibiotic, the infection for which the drug was prescribed, or another confounding factor.
WHAT THIS EVIDENCE MEANS FOR PRACTICE
Pending the publication of additional investigations, I believe that the guidance outlined below is prudent.
There may be instances in which trimethoprim-sulfamethoxazole should be used even early in pregnancy, such as to provide prophylaxis against Pneumocystis jiroveci infection in women with human immunodeficiency virus.
— Patrick Duff, MD
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Symptoms Of A Uti In Pregnancy
A UTI is an infection that occurs within the structures that pass urine as it is being eliminated from your body. These structures include the urethra, bladder, ureters, and kidneys.
During pregnancy, changes in the mothers body and urinary tract increase their risk of infection. Dilation of the ureters and other structures occur as the baby grows within the uterus. Hormonal changes can during this time can also make women more prone to UTIs.
Typical UTI symptoms include:
How Long Do Antibiotics Take To Work
The following antibiotic treatment is recommended by NICE 5,6:
- First choice – Nitrofurantoin for a course of 7 days
- Backup options – Cefalexin or Amoxicillin for a course of 7 days
Studies show that UTI symptoms can become much less severe after three to four days on antibiotics. 7,8 That being said, it is extremely important to complete the whole course of the antibiotics you are prescribed, even if symptoms clear up, so that none of the bacteria causing the infection are left behind and able to cause another infection.
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Which Antibiotics Are Safe To Take During Pregnancy
The United States Food and Drug Administration established a pregnancy risk categorization system in 1979. Drugs that may be used during pregnancy belong to category A and category B .
According to these classifications, the following classes of antibiotics are considered safe during pregnancy .
- Penicillins and their newer derivatives are most widely prescribed during pregnancy. A few common ones include Ampicillin, Amoxicillin, and their combinations with Clavulanate and Sulbactam. They are grouped under FDA pregnancy category B.
- Cephalosporins are category B drugs and are considered a first-line option in pregnant women. They may be used in patients allergic or intolerant to penicillin therapy. Cephalosporin combinations may be used with caution as published data about safety during pregnancy is inadequate.
- Carbapenems arecategory B drugs. They are generally reserved for pregnant women with penicillin- and cephalosporin-resistant infections with limited alternatives.
- Macrolide antibiotics are category B drugs, and the common ones are Azithromycin and Erythromycin. Erythromycin may be used during pregnancy for preventing Group B streptococcal infection in the newborn. However, some forms, such as erythromycin estolate, should be avoided .
- Other antibiotics considered pregnancy-safe are Vancomycin, Daptomycin, Fidaxomicin, Fosfomycin, and Nitrofurantoin.
What Is A Urine Infection And What Are The Symptoms
A urine infection is caused by germs which get into your urine. Usually the germs have come from your skin, and travelled up the tubes of the urinary system. The symptoms may depend on how far up your system the germs have travelled. The germs may cause:
- Asymptomatic bacteriuria. In this situation bacteria are found in your urine but are not causing any symptoms. You will only know you have it if your urine is tested.
- Bladder infection . This is common, both in pregnant and non-pregnant women. Typical symptoms are pain when you pass urine and passing urine more often. You may also have other symptoms such as pain in your lower tummy , blood in your urine, and a high temperature .
- Kidney infection . This is uncommon but may occur as a complication from cystitis or asymptomatic bacteriuria. It is usually a more serious infection, making you feel very unwell. Some or all of the possible symptoms may occur, which include:
- Pain in your side over your kidney.
- Having a high temperature.
- Symptoms of cystitis as above.
- Feeling generally unwell.
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Top 4 Antibiotics For Uti When Pregnant 2017
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Antibiotics for UTI when pregnant are sometimes a necessary evil. However, some are better than others.
Recent research published in CMAJ on May 1, 2017, reveals interesting findings of taking antibiotics when expecting. Some findings were surprising, while others have confirmed the long-standing opinion about potential side-effects of taking antibiotics when pregnant.
Finding #1: Antibiotics are associated with 60% increase in the risk of miscarriage
Every pregnant woman regardless of whether she takes antibiotics or not, has about 5-6% chance of miscarriage. When you take antibiotics during early stages of pregnancy it seems to increase the risk up to 9-10%.
However, it is hard to say what increases your risk more: the underlying infection or the antibiotic treatment.
Finding # 2: Some antibiotics are better than others
According to the findings, the following antibiotic groups are associated with an increased risk of miscarriage:
- macrolides ,
The findings reveal that the following antibiotics have not been connected with an increased risk of miscarriage:
Preventing Utis When Youre Pregnant
Having a UTI during pregnancy is no fun. It can put you and your baby at risk for future problems. To make matters worse, some women find they get UTIs repeatedly during pregnancy. Here are some things you can do to lower your risk of getting a UTI while youre pregnant.
Get regular prenatal care
Find a healthcare provider you trust. Follow their instructions throughout your pregnancy. The routine tests that are part of good prenatal care can detect a UTI and other medical conditions early, before they become a problem for you or your baby.
Drinking plenty of water is a key step in preventing and recovering from a UTI. Keep urine flowing through your system to help wash out any infection that might be getting started.
Protect your babys development, and keep your immune system working at its best, by avoiding any vitamin deficiencies.
The data around cranberry juice and cranberry supplements is mixed. Some large studies show that cranberries can prevent UTIs. Others say there isnt much effect. This may be due to different supplements containing different amounts of proanthocyanidin , which is thought to be the active ingredient. Either way, drinking cranberry juice every day can help you stay hydrated.
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How To Get Rid Of Urinary Tract Infection During Pregnancy
Top 10 Home Remedies for Urinary Tract Infection during Pregnancy 1 Increase Fluid Intake. Drinking plenty of water and fluids the entire day is 2 Frequent Urination. During pregnancy, you must urinate often so that bacteria do not grow inside 3 Keep the Body Clean and Dry. You should try to wear light and loose-fitting dresses
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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Uti Treatment During Pregnancy
Youâll take antibiotics for 3 to 7 days or as your doctor recommends. If your infection makes you feel uncomfortable, your doctor will probably start your treatment before you get your urine test results.
Your symptoms should go away in 3 days. Take all of your medication on schedule anyway. Donât stop it early, even if your symptoms fade.
Many common antibiotics — amoxicillin, erythromycin, and penicillin, for example — are considered safe for pregnant women. Your doctor wouldnât prescribe others, such as ciprofloxacin , sulfamethoxazole, tetracycline, or trimethoprim , that can affect your babyâs development.