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Urinary Tract Infection And Pregnancy

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What Is A Urine Infection And What Are The Symptoms

Urinary Tract Infection in Pregnancy | Signs, Symptoms, Complications & Treatment- Dr. H S Chandrika

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.

Can A Urine Infection Affect My Pregnancy

If you have a kidney infection when you are pregnant, you can feel very unwell. If left untreated, it may also cause problems such as early labour and/or a small baby. A kidney infection is uncommon but may develop as a complication from a bladder infection or from a urine infection. There may be no symptoms at first .

Urinary Tract Infections During Pregnancy

JOHN E. DELZELL, JR., M.D., and MICHAEL L. LEFEVRE, M.D., M.S.P.H., University of Missouri-Columbia School of Medicine, Columbia, Missouri

Am Fam Physician. 2000 Feb 1 61:713-720.

See related patient information handout on urinary tract infections during pregnancy, written by the authors of this article.

Urinary tract infections are common during pregnancy, and the most common causative organism is Escherichia coli. Asymptomatic bacteriuria can lead to the development of cystitis or pyelonephritis. All pregnant women should be screened for bacteriuria and subsequently treated with antibiotics such as nitrofurantoin, sulfisoxazole or cephalexin. Ampicillin should no longer be used in the treatment of asymptomatic bacteriuria because of high rates of resistance. Pyelonephritis can be a life-threatening illness, with increased risk of perinatal and neonatal morbidity. Recurrent infections are common during pregnancy and require prophylactic treatment. Pregnant women with urinary group B streptococcal infection should be treated and should receive intrapartum prophylactic therapy.

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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.

What Treatment Options Are Available

Urinary Tract Infection (UTI) In Pregnancy: Symptoms &  Treatment

UTIs can be safely treated with antibiotics during pregnancy. Urinary tract infections are most commonly 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, contractions, or if after taking medicine for three days, you still have a burning feeling when you urinate.

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Safety Of Antimicrobial Treatment

Nearly all antimicrobials cross the placenta, and some of them may exert teratogenic effects. Commonly accepted antibiotics used in treating UTIs during pregnancy, regardless of its period, include derivatives of penicillin and cephalosporins, particularly those with low protein-binding ability , all of FDA pregnancy category B .

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 antibioticsamoxicillin, 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.

What Is A Urinary Tract Infection

[O& G] UTI in pregnancy, pyelonephritis, recurrent UTI

A urinary tract infection is an infection of the urinary system. UTIs are the most common bacterial infection that women develop during pregnancy. They can occur in different parts of the urinary tract, including the bladder , urethra or kidneys . Sometimes when a UTI develops and bacteria are detected in the urinary tract, you may not have any symptoms of an infection. This is known as asymptomatic bacteriuria.

While anyone can get a UTI, they are much more common in women than men and they are also more likely to occur in the very young and the elderly.

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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.

What Is A Uti

A UTI is a bacterial infection of the urinary tract, which includes the bladder , the urethra or, in more serious cases, the kidneys .

The urinary tract removes waste and extra water from the body. It’s made up of two kidneys, where urine is produced, two ureters, which carry urine to your bladder, the bladder itself, which collects and stores the urine, and the urethra, the tube that sends the urine out of your body.

Sometimes, normal bacteria from your skin and other areas can trespass into the urinary tract, where they multiply fast, resulting in infection.

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Group B Streptococcal Infection

Group B streptococcal vaginal colonization is known to be a cause of neonatal sepsis and is associated with preterm rupture of membranes, and preterm labor and delivery. GBS is found to be the causative organism in UTIs in approximately 5 percent of patients.31,32 Evidence that GBS bacteriuria increases patient risk of preterm rupture of membranes and premature delivery is mixed.33,34 A randomized, controlled trial35 compared the treatment of GBS bacteriuria with penicillin to treatment with placebo. Results indicated a significant reduction in rates of premature rupture of membranes and preterm delivery in the women who received antibiotics. It is unclear if GBS bacteriuria is equivalent to GBS vaginal colonization, but pregnant women with GBS bacteriuria should be treated as GBS carriers and should receive a prophylactic antibiotic during labor.36

When Is My Urine Checked During Pregnancy

How to Treat a Urinary Tract Infection 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.

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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.

Related reading:Tips to prevent involuntary urine leakage during and after pregnancy

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.

What Causes A Urine Infection

Most urine infections are caused by bacteria which come from your own bowel. They cause no harm in your bowel but can cause infection if they get into other parts of your body. Some bacteria lie around your back passage after you pass a stool . These bacteria can sometimes travel to your urethra and into your bladder. Some bacteria thrive in urine and multiply quickly to cause infection.

Less commonly there may be other causes of a urine infection. If you have to have a tube passed into your bladder, it is easier for germs to directly reach your bladder, and this may make urine infection more likely. Occasionally for people whose immune systems are not working well, the infection may spread through the bloodstream rather than up the urinary tubes.

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Strengths And Limitations Of Study

The strengths of this study lie mainly in the method used for data collection. The advantage of using an online forum to collect data was that it provided access to a wide range of participants across the UK. Online forum postings increase the perceived sense of anonymity in participants, which can increase disclosure compared to face-to-face interviews. Data was also immediately available for analysis and circumvented transcription errors arising from interviews.

Using an online forum, however, also contributed to the limitations of this study. Women used descriptive text and emoticons to express their feelings, but using an online forum could result in a loss of insight that facial expressions or verbal tone can offer to exploring perceptions. It was difficult to characterise the exact demographics of website users and only views of women who had access to the internet and had subscribed to the forum could be analysed. Different cultural groups in the UK may also have different norms of behaviour in pregnancy and the views of women from varying backgrounds may differ from what was captured from the forum. Therefore, the interpretation and transferability of the results should be made within this context and broad generalisations may not be appropriate.

What Are The Symptoms Of Utis During Pregnancy

UTI in Pregnancy – CRASH! Medical Review Series

Common symptoms of a UTI during pregnancy are similar to those that you might experience at any other time, and include:

  • a burning sensation when you pass urine
  • feeling the urge to urinate more often than usual
  • urinating before you reach the toilet
  • feeling like your bladder is full, even after you have urinated
  • urine that looks cloudy, bloody or is very smelly
  • pain above the pubic bone

Sometimes the first sign of an infection is a faint prickly sensation when you pass urine. If the infection is more advanced and has moved up to the kidneys, you may also experience fever with a particularly high temperature, back pain and vomiting.

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Symptomatic Urinary Tract Infection

About 1520% of women with pyelonephritis have bacteremia . They may develop various complications, such as acute kidney injury, anemia, hypertension, preeclampsia, sepsis and septic shock, hemolysis, thrombocytopenia, and acute respiratory distress syndrome, particularly if treatment is initiated too late . Although these associations have not always been proved to be causal, most of the complications seem to be due to renal or other tissue damage caused by bacterial endotoxins and a systemic inflammatory response with endothelial injury .

A number of observational studies have demonstrated the relationship between maternal symptomatic UTI and the risk of premature delivery and lower birth weight . The frequency of preterm deliveries in women with acute pyelonephritis is significantly higher than in women free of this complication, and pyelonephritis seems to be an important independent risk factor for delivery before 37 weeks gestation . However, again, a substantial heterogeneity between these studies, together with many possible biases, makes it difficult to establish the overall contribution of UTI to preterm birth . A rare but severe complication is the transmission of the infection onto the newborn baby . Very often the transmitted infection originates from a heavily colonized birth canal, usually with GBS .

Not All Urine Tests Are The Same

In the third trimester, well likely test your urine for the presence of protein or glucose, which can indicate high blood pressure or gestational diabetes. Around this time, we also test urine for sexually transmittable diseases such as chlamydia and gonorrhea, which can be transferred to your baby.

Neither of these tests will tell us whether you have a UTI. If youre experiencing UTI symptoms, please tell us so we can perform the appropriate test and begin treatment.

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Can A Uti Cause Contractions During Pregnancy

Urinary tract infections are not associated with preterm labor, according to research published in the Journal of the Chinese Medical Association. However, if a urinary tract infection is left untreated, it can progress to a kidney infection. And a kidney infection during pregnancy can modestly increase your chances of early contractions and delivery. Research published in the American Journal of Obstetrics & Gynecology notes that women diagnosed with acute pyelonephritis in pregnancy have a 10.3 percent chance of preterm delivery compared with the 7.9 percent chance among women without a kidney infection during pregnancy.

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Preventing Utis During Pregnancy

Urinary Tract Infection And Pregnancy / Antimicrobial Prescribing In ...

While UTIs might happen whatever precautions you take, a few steps can help reduce the odds youll suffer from a UTI during pregnancy:

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

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What Are The Symptoms Of Uti In Pregnancy

Common symptoms of a urinary tract infection are:

  • pain when you pass urine
  • passing urine more often
  • pain in the lower stomach area
  • blood in your urine
  • urine that looks cloudy or smells more than normal.
Warning signs
If you have a high fever, shakes, back pain or feel generally unwell, with or without urinary symptoms, seek medical advice right now. You may have pyelonephritis, a more serious infection of the kidneys which needs immediate treatment.

Urinary Tract Infection In Pregnancy

, MD, PhD, University of Texas Health Medical School at Houston, McGovern Medical School

Urinary tract infection Introduction to Urinary Tract Infections Urinary tract infections can be divided into upper tract infections, which involve the kidneys , and lower tract infections, which involve the bladder , urethra… read more is common during pregnancy, apparently because of urinary stasis, which results from hormonal ureteral dilation, hormonal ureteral hypoperistalsis, and pressure of the expanding uterus against the ureters. Asymptomatic bacteriuria occurs in about 15% of pregnancies and sometimes progresses to symptomatic cystitis Cystitis Bacterial urinary tract infections can involve the urethra, prostate, bladder, or kidneys. Symptoms may be absent or include urinary frequency, urgency, dysuria, lower abdominal pain… read more or pyelonephritis Acute pyelonephritis Bacterial urinary tract infections can involve the urethra, prostate, bladder, or kidneys. Symptoms may be absent or include urinary frequency, urgency, dysuria, lower abdominal pain… read more . Frank UTI is not always preceded by asymptomatic bacteriuria.

Asymptomatic bacteriuria, UTI, and pyelonephritis increase risk of

  • Nitrofurantoin

  • Trimethoprim/sulfamethoxazole

After treatment, proof-of-cure cultures are required.

Women who have pyelonephritis or have had more than one UTI may require suppressive therapy, usually with TMP/SMX or nitrofurantoin, for the rest of the pregnancy.

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