urinary tract infection in pregnancy
A urinary tract infection (UTI) is caused by bacteria (germs) that get into your urine and urinary tract (ie. bladder, kidneys).
What causes a urinary tract infection?
Most urinary tract infections are caused by bacteria that 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 anus (back passage) after a bowel motion. These bacteria can sometimes travel into your bladder. Some bacteria thrive in urine and multiply quickly to cause infection.
Women are more prone to urinary tract infections than men. Pregnant women are more prone to urinary tract infections than non-pregnant women. This may be due to the hormone changes of pregnancy that affect the urinary tract and tend to slow down the flow of urine.
What is the risk of a urinary tract infection when you are pregnant?
If you have a UTI when you are pregnant, it may cause problems such as early labour. Bacteria in the urine left untreated may lead to pylonephritis (kidney infection), which has the potential for kidney damage. A kidney infection is uncommon but may develop as a complication from cystitis (inflammation of the bladder) or from a urinary tract infection with no symptoms at first (asymptomatic bacteriuria).
Types of urinary tract infections include:
Bacteria are found in your urine, but are not causing any symptoms e.g. Pain and or frequency when passing urine.
Bladder infection (Cystitis)
This is common in both pregnant and non pregnant women. Typical symptoms are pain when you pass urine, and passing urine frequently. You may also have other symptoms such as pain in your lower abdomen, blood in your urine on testing, and fever (high temperature and generally feeling unwell, flu/type symptoms).
Kidney infection (pylonephritis)
This is uncommon, but may occur as a complication from cystitis or asymptomatic bacteriuria. Symptoms may include: pain in a loin (side of the abdomen over your kidney), fever, (high temperature and generally feeling unwell, flu-type symptoms), feeling sick (nausea), vomiting and/or diarrhoea, and blood in your urine on testing. You may also have symptoms of cystitis. Not all the symptoms may develop, and sometimes a kidney infection can just cause vague symptoms such as feeling generally unwell.
Urine checks during pregnancy
• You should have routine urine testing as early as possible in pregnancy.
• Treatment may be advised if any bacteria are found – even if you have no symptoms (asymptomatic bacteriuria).
• Also, if bacteria are found, you should have regular routine urine testing throughout the pregnancy.
• You should also have a urine test if you develop symptoms of bladder infection (cystitis) or kidney infection (pylonephritis) at any stage during pregnancy.
• You will have your urine tested at each antenatal visit to you GP and to the hospital.
• You may be asked to provide a second clean specimen of urine for testing.
What is the treatment of a urinary tract infection when you are pregnant?
A course of antibiotics is the usual treatment. Any symptoms will usually improve within a few days. However, it is very important that you complete your course of antibiotics to treat the urinary tract infection.
If your symptoms have not gone completely once the course of antibiotics is completed you should see a doctor/ midwife. Also you should return to your GP/midwife or hospital if your symptoms worsen after a few days.
A change of antibiotic may be necessary in some cases if the bacterium is found to be resistant to the first antibiotic. If the UTI is not improving or if a pylonephritis develops an admission to hospital may be necessary to give fluids and antibiotics into your vein.
Your midwife and doctor will advice you what is the appropriate treatment.
Antibiotics will also be recommended during labour if your urine sample at any time during the pregnancy had grown bacteria called Group B Streptococcus. (These antibiotics are in addition to the other doses of antibiotics used to treat the UTI during pregnancy). These antibiotics are to help protect your baby from these bacteria.
An information Leaflet on Group B Streptococcus is available in this unit.
Paracetamol if required will usually ease any pain, discomfort, or fever (high temperature). Your midwife or doctor will advise you.
C) Drinking fluids
If you have a UTI it is advisable to drink water (if tolerated) to help keep hydrated.
D) Personal hygiene:
Personal hygiene is important. It is recommended to shower frequently – no baths, no abrasive soaps/perfumes. Maternity pads should be changed frequently. If vaginal discharge is increased or signs of thrush e.g. itching, soreness and irritation contact your midwife or doctor. If you partner complaints of infection he should visit his doctor for advice also.
Follow on treatment
It is usual to send a repeat urine sample to the laboratory for testing one week after the course of antibiotic treatment is completed, to check that your urine is clear of bacteria.