Urinary tract Infection (UTI) is a bacterial infection of the urinary tract which is quite common during pregnancy, especially in first trimester with increased risk from 6th to 24th week of pregnancy. E.coli which normally lives in the intestines of humans is the most common bacteria responsible for causing UTI.
Pregnant women are more prone to develop UTI due to
- Lowered immunity.
- Relaxed smooth muscles.
- External, direct pressure of the expanding uterus on the urinary bladder causing some amount of urine to retain in the bladder which is a good medium for bacterial growth.
Symptoms and signs of UTI:
- Pain and burning sensation while passing urine.
- Urge to urinate and increased frequency of passing urine.
- Blood in urine, cloudy urine which may be foul smelling or has an unusually strong smell.
- Cramps of lower abdomen.
- Fever with chills.
Management:
An ideal urine sample is a mid-stream urine collected first thing in the morning, after cleaning private parts thoroughly.
A diagnosis of UTI is made by signs, symptoms and presence of bacterial counts in urine by urine analysis.
Painkillers and a course of antibiotics for 3-7 days are prescribed to completely treat UTI. Certain antibiotics like nitrofurantoin, beta lactams can be safely taken in pregnancy.
Follow up:
Infection is not completely subsided in 30% of women in spite of the course of antibiotics. Hence, a repeat urine culture is done after 1 week of completing the course of antibiotic medications to confirm that the infection has subsided completely.
If the infection doesn’t subside, a suppressive therapy of antibiotics once a day may be important till delivery.
A urine culture once every month till the end of pregnancy may be done to ensure the infection doesn’t recur.
Complications:
A UTI if left untreated may be harmful to the baby due to complications like
- Acute cystitis in mother (infection of urinary bladder).
- Pyelonephritis in mother(infection of kidneys).
- Preterm delivery.
- Premature Rupture of Membranes (PROM).
- Intrauterine Growth Restriction (IUGR).
- Low birth weight of the baby.
- Chorioamnionitis (infection of membranes covering the baby in pregnancy).
- Anemia.
Consulting the doctor immediately is important if the symptoms worsen, persists after completing the course of antibiotic treatment, nausea, vomiting, uterine contractions, pain in loin (infection of kidney) occur.
Prevention and a few tips at home for treating UTI:
- Drink plenty of water of at least 2-3 liters a day (6-8 glasses a day), unsweetened cranberry juice regularly which may help in flushing out the bacteria through urine.
- Avoid refined, processed foods, sweetened drinks, sugar, fruit juices, caffeine, alcohol which may irritate the bladder and trigger an infection.
- Hot packs/ warm compresses applied locally over the lower abdomen which may help in giving relief from pain and discomfort.
- Urinate whenever there is a feeling of urination and completely empty the bladder to prevent retention of urine.
- Urinate before and after intercourse.
- Avoid intercourse during an episode of UTI.
- Maintain a very good personal hygiene by cleaning private parts thoroughly with plain water, tissues, mild scented soaps every time after using washroom or having intercourse.
- Avoid using strong scented soaps, douches, powders to clean private parts.
- Wash and change clothes and undergarments daily.
- Wear loose, comfortable, cotton clothes and avoid wearing tight fitting pants, leggings.
Reference:
http://americanpregnancy.org/pregnancy-complications/urinary-tract-infections-during-pregnancy/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379362/
– Dr. Divya Teja Pasupuleti
#Thinkhealth blog 