What Cause Urinary Tract Infections (UTIs) During Pregnancy?

Urinary tract infection or UTI is an infection of the urinary system. It includes infections that affect kidneys, ureters, urethra, and the urinary bladder. If you are pregnant, there may be an increased chance of developing a UTI, for pregnancy may increase the risk of the infection. Pregnancy-related hormonal changes and poor flow of urine are some of the common risk factors (1).

Read this post to know the causes, symptoms, treatments, and preventive measures for UTI in pregnancy.

Is UTI Dangerous During Pregnancy?

Although UTI is a treatable condition, timely medical attention must be sought. If left untreated, UTI during pregnancy may cause pregnancy complications and poor pregnancy outcomes, including premature labor and low birth weight (2). Further, The infection may enter the bloodstream and spread to other organs.

Some commonly found pathogens causing UTI are Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus saprophyticus (3). Some opportunistic pathogens, such as K.pneumoniae, are highly contagious and form biofilms. They may cause catheter-associated UTI and require an intensive care unit setup. They can cause fetal complications, including neonatal sepsis (4).

Why Are UTIs More Common During Pregnancy?

UTIs can occur at any time, but pregnancy may increase the risk of acquiring UTI due to the following reasons (5):

1. During pregnancy, the level of progesterone hormone is elevated, causing the ureters to dilate and slowing down the flow of urine.

2. The growing baby pushes the uterus against the ureters, further slowing the urine flow. Thus, the bladder does not get fully emptied and the leftover urine can be a source of infection.

3. Urinary reflux increases the risk of urine flowing back to the kidney, allowing more time for the bacteria to reach the kidney and multiply (1).

What Are The Symptoms Of UTI During Pregnancy?

Some of the symptoms of UTI during pregnancy are (6):

• Burning sensation while urinating

• Frequent urination

• Foul-smelling urine with a dark, cloudy, or blood-tinged appearance

• Discomfort or pain in the lower abdomen and back

• Chills

• Fever

• Vomiting

Can You Have UTI Without Symptoms?

Asymptomatic bacteriuria is a UTI during pregnancy without visible symptoms. It may cause kidney infection and pose a risk of poor pregnancy outcomes. However, most patients with asymptomatic bacteriuria do not develop symptomatic UTI in the future.

The illness may be identified in the first prenatal check-up. In case of a negative report, the risk of asymptomatic bacteriuria in a later stage of pregnancy is considerably low. In case of a positive result, you may be treated with antibiotics as usual. On recovery, regular urine cultures are conducted to ensure there is no infection (7).

What Are The Causes And Risk Factors Of UTI During Pregnancy?

Other than hormonal changes, here are some of the causes and risk factors of UTI during pregnancy are (1) (5)

1. Bacteria from the bowel: coli, the most common UTI-causing bacteria, can come from the bowel as the rectum is near the urethra.

2. Bacteria from the intestine: Certain bacteria, such as group B streptococcus, are part of the gut microbiota and may cause UTI.

3. Intercourse: Intercourse during pregnancy may cause UTI due to the pushing of bacteria near the vagina into the urethra.

How Is UTI Diagnosed During Pregnancy?

UTI diagnosis is routinely carried out during all prenatal visits using urine samples of expectant mothers. The sample is then examined for white blood cells or bacteria (8). Further, a urine culture and antibiotic susceptibility test identify the type of bacteria and response to antibiotics. Based on the tests, you may be prescribed a course of antibiotics.

The following diagnostic imaging tests are used to understand the extent of infection and damage caused by the UTI during pregnancy (9):

• Ultrasound: It uses sound waves to generate a two-dimensional map of the body part. It helps the doctor better understand the urinary tract blockage and perform differential diagnosis.

• Magnetic resonance imaging (MRI): MRI is a non-invasive method of imaging using non-ionizing radiation and is safe to use during pregnancy. It generates clear images of the infected region.

• Computerized tomography (CT): It generates a 3D scan of the urinary tract to identify blocks or stones. Although a CT scan is not the method of choice during pregnancy, a doctor may evaluate its risk-to-benefit ratio and take a call.

What Are The Treatment Options For UTI During Pregnancy?

UTI is treatable with antibiotics. Your doctor will decide the right treatment regime for you, and you may recover within a week.

Some of the safe antibiotics used for the treatment of UTI during pregnancy are (10)

• Amoxicillin-clavulanic acid

• Erythromycin

• Penicillin

• Cephalexin

• Nitrofurantoin

• Fosfomycin

What Are The Home Remedies To Treat UTI During Pregnancy?

Here are some home remedies that may help recover from UTI during pregnancy (6) (11) (12):

1. Drink plenty of water

2. Consume cranberries juice and vitamin C

3. Urinate when the urge arises

4. Use loose cotton underwear

5. Wipe from front to back in the toilet

6. Avoid scented or irritating feminine hygiene products

7. Have a healthy and nutritious diet

8. Practice good hygiene

How To Prevent UTI During Pregnancy?

Here are some preventive measures to reduce the risk of UTI during pregnancy (11) (13):

1. Avoid refined foods, caffeine, and alcohol

2. Take vitamin C supplements

3. Urinate before and after intercourse

4. Keep the genital area clean

5. Don’t use the bathtub for long periods

UTI is a painful illness that commonly occurs during pregnancy. The infection is caused by opportunistic pathogens that linger around the body. The condition is treatable, and many antibiotics are available to safely use during pregnancy. However, if left untreated, it may cause pregnancy complications and adverse pregnancy outcomes.

References

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