Cloudy Urine During Pregnancy: Causes, Diagnosis And Home Remedies

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Pregnancy is associated with several physiological and biochemical changes in a woman’s body. One such change is cloudy urine when pregnant, which might occur for several reasons. In addition, changes in the consistency of urine might also be observed during this time. Some common reasons include bacterial or fungal infection, dehydration, or preeclampsia.

Read on to know about the causes of cloudy urine when pregnant, factors that influence it, and treatment management for underlying causes.

Causes Of Cloudy Urine During Pregnancy

The presence of substances such as white blood cells, proteins, or vaginal secretions mixed with urine may impart a cloudy appearance to it. Changes in concentrations of hormones in the urine or even some foods you eat may cause cloudy urine during pregnancy. Other conditions responsible may include the following.

1. Dehydration

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The body’s water requirements increase during pregnancy. Water is also lost due to morning sickness, which usually continues up to the 14th week of pregnancy. Dehydration or inadequate fluid intake could concentrate your urine, making it darker in color, cloudy, or denser.

Did you know?

Severe nausea and vomiting (hyperemesis gravidarumⁱXContinuous morning sickness and vomiting during pregnancy that causes weight loss and dehydration ) during pregnancy can cause significant dehydration and loss of more than 5% of a woman’s body weight (12).

2. Preeclampsia

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It is a condition characterized by increased blood pressure and proteinuria (protein in urine), which could be accompanied by kidney and liver problems in a pregnant woman. Other symptoms include swelling in the hands and feet, headache, nausea, or problems with vision.

It may have serious consequences such as convulsionsⁱXA condition characterized by uncontrollable shaking of the body due to rapid muscle contraction and relaxation. and kidney or liver failure in the mother and cause preterm birthⁱXBirth of a baby before the full 37 weeks of pregnancy. . Preeclampsia generally occurs in the second trimester (after 20 weeks) and may cause cloudy urine due to the proteins present in it or due to poor kidney function (1).

The graph below shows that preeclampsia can develop at any stage of pregnancy, especially after 33 weeks of gestation. However, the prevalence of preeclampsia has been shown to decrease by about 23% with the implementation of the FMF (Fetal Medical Foundation) screening program from the first trimester. Although these reductions did not approach statistical significance, the graph showed a reduction pattern of 38%, 34%, and 19% for early, preterm, and term preeclampsia, respectively. Additionally, there were no preeclampsia cases seen in the FMF screening group before 30 weeks of gestation.

Occurrence of preeclampsia in women by gestational weeks at birth

Health fact

The American College of Obstetricians and Gynecologists recommends low dose aspirin (81mg/day) as a preventive for pregnant women at high risk of developing preeclampsia (13).

3. Kidney stones

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Stones may be formed in kidneys (nephrolithiasis) or other parts of the renal system such as ureters or urethra (urolithiasis). They are composed mainly of calcium oxalate or phosphate and less commonly of uric acid, struvite, and cystine. Stones are rare during pregnancy but may cause complications, such as renal failure, in some cases. Besides flank pain and difficulty in urination, hematuria (blood cells in urine) may occur, causing the urine to turn cloudy (2).

4. Urinary tract infection (UTI)

The growing fetus exerts pressure on the adjacent urinary bladder, decreasing its capacity and causing a pregnant woman to urinate frequently. Additionally, hormonal changes (progesterone relaxes smooth muscles) cause physiological changes in the urinary tract, making it prone to urinary tract infection(UTI) or bladder infections.

UTIs are mostly bacterial infections that start from the urinary tract and, if left untreated, may reach the kidneys and cause pyelonephritis (inflammation or infection in kidneys).

Cloudy urine with a strong smell or a tinge of blood may indicate UTI. Additionally, fever, chills, flank pain, and nausea may occur (3) (4).

5. Fungal infections

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The acidic environment of the vagina changes during pregnancy, increasing the risk of yeast overgrowth. Increased vaginal discharge is common during pregnancy, but a fungal (yeast) infection may cause excess cottage cheese-like discharge with foul smell, vaginal itching, or painful urination. Urine may become cloudy if it mixes with the vaginal discharge (5).

6. Sexually transmitted diseases (STDs)

Sexually active pregnant women may also contract STDs such as chlamydiaⁱXA sexually transmitted disease caused by bacteria and is spread through vaginal fluid and semen. , gonorrhea, and syphilis. The National Vital Statistics Reports revealed the incidence of chlamydia, gonorrhea, and syphilis among women giving birth in the United States, with rates of 1,843.9, 310.2, and 116.7 per 100,000 births, respectively. Untreated STDs could increase the risk of pregnancy complications, such as preterm birth and other fetal health issues. STDs may not cause symptoms initially, but you should look out for excess vaginal discharge, abdominal or pelvic pain, and painful urination. Urine analysis may show pyuria or the presence of white blood cells in urine (produced when the body fights infection), giving urine a cloudy appearance (6).

Diagnosis Of Reasons That Cause Cloudy Urine

Preliminary diagnosis depends on the symptoms accompanying cloudy urine in pregnant women. Inform your gynecologist about any unusual signs and symptoms suggestive of an underlying condition. It may be further diagnosed through the following procedures.

• Urine analysis refers to testing a sample of your urine for the presence of substances that would help in identifying the underlying condition. For example, UTI and certain STIs are detected based on the type of bacteria found in urine cultures. The presence of protein may indicate preeclampsia if the woman is already hypertensive (1). The American College of Obstetrics and Gynecology recommends a urine cultureⁱXA test to check for any bacteria or germs in the urine that can lead to a urinary tract infection. at your first prenatal visit and a re-analysis during the third trimester to rule out harmful infections (7).

• Blood tests to determine liver and kidney functions or screen for infections.

• Imaging techniques such as an ultrasound or magnetic resonance urography are performed to detect kidney stones (2).

Treatment For Cloudy Urine During Pregnancy

The treatment will depend on the underlying cause. The condition may resolve with some home remedies, or your doctor may suggest specific treatment depending on the diagnosis.

1. Stay hydrated

Proper hydration with ample water intake may solve the issue. However, you may need intravenous fluids if dehydration is severe or the water intake is impossible.

Quick fact

A daily intake of 64 to 96 ounces of water (8 to 12 cups) is recommended for pregnant women (14).

2. Get rest and frequent follow-ups

For mild cases, you may be advised to rest and reduce salt intake, but your doctor may increase the frequency of prenatal check-ups to monitor fetal development. Severe preeclampsia may require treatment with antihypertensive and anticonvulsant (anti-seizure) medications (8).

3. Include prescribed medications

Management depends on the size and location of the stones. Most of the small ones pass spontaneously in a few weeks. Your physician may advise you to increase water intake and prescribe pain medications. Make sure to avoid taking over-the-counter painkillers without consulting your doctor to prevent any potential risks to maternal health. The need for invasive treatment depends on the stage of pregnancy and complications that may arise due to larger stone size, infection, or severe pain (2).

4. Try home remedies

Mild infections may be treated with home remedies such as (9):

• Drinking more water to flush bacteria

• Cranberry as juice or in salads prevents bacteria from sticking to the walls of the urinary tract

• Probiotics such as yogurt that contains beneficial bacteria (lactobacillus) that restricts the growth of harmful bacteria

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Antibiotics may be prescribed in case of persistent or severe infection.

5. Prefer topical medication for fungal infections

Topical antifungal creams or suppositories applied inside the vagina are preferred for safe prenatal care, as most oral antifungal medications are contraindicated. Consult your gynecologist before using any OTC medication (5).

6. Get an accurate diagnosis for STDs

STDs need to be accurately diagnosed, and only prescribed antibiotics should be used for treatment.

Infographic: Is Cloudy Urine The Same As Foamy Urine?

Cloudy and foamy types of urine are cause for concern since they indicate an underlying medical condition requiring treatment. Urine is normally colorless and odorless and does not have bubbles. Go through the infographic to know the difference between cloudy and foamy urine.

Illustration: Momjunction Design Team

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Dr. Irene (Eirini) OrfanoudakiPhD, MD

Dr. Irene (Eirini) Orfanoudaki is a gynecologist-obstetrician, having a private practice in Heraklion, Crete, and collaborating with private health clinic 'MITERA' - Euromeda in Heraklion. With around 21 years of experience as a gynecologist-obstetrician, she specializes in ultrasound, colposcopy, minimal and advance gynecologic surgery, aesthetic gynecology, fertility consulting, menopause consulting, operative obstetrics, high-risk pregnancy, normal deliveries, antenatal, intra-parum, postnatal care,...more

• Dr. Nisarg PatelMBBS, MS

  Dr. Nisarg Patel is a gynecologist, obstetrician, and laparoscopic surgeon from Ahmedabad, India, with over 13 years of experience in the field. He did his post graduation in Obstetrics and Gynecology from Pravara Institute of Medical Sciences, Ahmednagar, and holds a fellowship of Reproductive Medicine.
  
  Dr. Nisarg Patel is a gynecologist, obstetrician, and laparoscopic surgeon from Ahmedabad, India, with over 13 years of experience in the field. He did his post graduation in Obstetrics and Gynecology from Pravara Institute of Medical Sciences, Ahmednagar, and holds a fellowship of Reproductive Medicine.

Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer. Her research work was published in international journals and publications, such...more

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her post graduation in Biotechnology from MITS School of Biotechnology,...more