What is a UTI?
A Urinary Tract Infection (UTI) is an infection of part of your body's urinary system- this includes kidneys ureters (tubes that carries urine from your kidneys to your bladder) bladder and urethra (a short tube that carries urine from your bladder to outside your body). This infection is usually caused by bacteria and can lead to various complications particularly in pregnant women. These include, pre-term birth, low birth weight, and kidney infection in the mother.
Urinary tract infections can happen to anyone. However they are more common in women, especially pregnant women due to the female body’s unique urinary system structure and the changes that occur during pregnancy.
What causes UTIs in pregnancy?
Pregnant women are at increased risk for UTIs starting in week 6 through to 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 UTI during pregnancy.
Also, in pregnancy, there is an increase of the hormone progesterone. This hormone causes changes in the urinary tract and increases the likelihood of UTI. Some changes in hormones can also lead to vesicoureteral reflux, a condition in which your urine flows back up from your bladder to your kidneys, increasing the risk of infection.
Finally, during pregnancy, there is an increase in the amount of sugar, proteins, and hormones in the urine thus creating the perfect condition for bacteria to grow. This coupled with the changes in the urinary system make it easier for pregnant women to get urinary tract infections.
Signs and symptoms of UTI
If you have a UTI, you may have:
an urgent need to urinate, or urinating more often
trouble urinating
a burning sensation or cramps in your lower back or lower belly
a burning feeling when you urinate
urine that looks cloudy or has an odour
blood in your urine, which can turn it red, bright pink, or cola-coloured
fever
In pregnancy, women are also more susceptible to asymptomatic UTIs, meaning that you have significant bacteria in your urine, but your urinary tract is free of signs and symptoms. Experiencing no symptoms, however, does not mean that asymptomatic UTIs are benign.
Research shows that if asymptomatic UTIs are left untreated, 30 percent of pregnant women will go on to develop a symptomatic UTI, and half of those women will eventually be diagnosed with acute pyelonephritis (a kidney infection). Therefore, it is exceptionally important to attend antenatal appointments so that asymptomatic UTIs may be detected, through the routine urine analysis test, and treated timeously.
Are UTIs dangerous during pregnancy?
UTIs can rapidly progress to a kidney infection in pregnancy, which can be much more dangerous than a kidney infection in non-pregnant women. Severe infections can lead to respiratory problems and sepsis (dysregulated response to infection), which can then lead to preterm labour or even the need to urgently deliver the baby.
A part from a kidney infection, simply having a UTI during pregnancy appears to possibly be a contributing factor to low birth weight. Women who have a UTI in pregnancy also have a 1.31-fold higher risk of developing preeclampsia, a pregnancy complication characterized by high blood pressure.
How can I prevent a UTI?
To try to avoid getting a UTI by:
drinking at least eight glasses of water a day;
wiping yourself from front to back when you go to the bathroom;
emptying your bladder shortly before and after sex;
choosing a water-based lubricant (if needed);
staying away from douching;
avoiding strong feminine deodorants or soaps that may cause irritation;
washing your genital area with warm water before sex;
wearing cotton underwear;
opting for a shower instead of a bath;
wearing loose fitted pants;
urinating often;
Avoiding alcohol, citrus juices, spicy food, and caffeinated drinks, which can irritate your bladder; and
drinking cranberry juice.
How is a UTI treated?
UTIs can be safely treated with antibiotics during pregnancy. UTIs are mostly treated by antibiotics. Doctors usually prescribe a 3-7 day course of antibiotics that is safe for you and the baby. Call your doctor if you have fever, chills, lower stomach pains, nausea, vomiting, or contractions, or if after taking medicine for three days, you still have a burning feeling when you urinate.
Take Home Message
UTI's are common during pregnancy. They can cause a lot of complications if not treated early - so, it is important to attend antenatal checkups to detect urinary tract infections early. Care must be taken to prevent UTIs.
This article is written by Dr. Itumeleng Buti (MBChB)
References
1. WebMed. UTIs During Pregnancy. [Internet] WebMed [updated 2020 September 14; Cited 2022 April 13] available from: https://www.webmd.com/women/guide/pregnancy-urinary-tract-infection.
2. Holly Pevzener. Urinary Tract Infections During Pregnancy: Symptoms, Treatment, and Common Questions. [ Internet] Everyday Health. [ Updated 2020 March 16; Cited 2022 April 13] Available from: https://www.everydayhealth.com/urinary-tract-infection/utis-pregnancy-symptoms-treatment-common-qs/
3. American Pregnancy Association. Urinary Tract Infection During Pregnancy. [Cited 2022 April 2022] Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/urinary-tract-infections-during-pregnancy/
4. William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 48.
5. Cleveland Clinic. Urinary Tract Infections. [Internet] [Updated 2020 July 3; Cited 2022 April 13 2022] Available from: https://my.clevelandclinic.org/health/diseases/9135-urinary-tract-infections.
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