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

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Pregnancy may be a beautiful phase, but it has its downsides.

Your immunity is usually low at this time, leaving you susceptible to infections such as the urinary tract infection or UTI.

According to research, about 8% of pregnant women experience UTIs (1) that affect the kidneys, bladder and sometimes the ureter.

UTI can make you highly uncomfortable, but it is treatable. Here, MomJunction tells you more about the condition and the options to deal with it.

What Is Urinary Tract Infection?

Urinary tract infections, also known as bladder infections (urine infection), develop when bacteria gets into the urinary tract.

UTI can be classified into upper UTI involving the kidneys and ureters, and lower UTI affecting kidneys and bladder. Women are more likely to contract this infection as the female urinary anatomy makes it easy for the bacteria to enter into the urinary tract from the vagina and rectal regions. The risk of UTIs is high from the 6th to 24th week of pregnancy (2).

A UTI is more than just frequent urination or a burning sensation in the vagina. UTI can be the infection of any part of the urinary tract, from the kidneys where urine is formed, to ureters and the urinary bladder where urine is stored, and urethra which passes urine outside the body (3).

Knowing its causes is the first step to prevent infection.

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Causes And Types Of Urinary Tract Infections

You can develop a urinary tract infection during pregnancy due to any of the following factors (4):

  • Bacteria, most commonly E.coli and chlamydia present on your skin, in your rectum or vagina.
  • Changes in the anatomy and function of the urinary tract, leading to kidney enlargement, compression of ureters and bladder.
  • The bladder does not empty well during pregnancy, leading to concentrated urine that contains sugars, hormones, and proteins rather than just acids.

The above factors lead to the following types of UTIs during pregnancy.

  1. Cystitis or bladder infection: Sometimes, bacteria gets lodged in your bladder where it strives and grows. As a result, you will experience a burning sensation and pain while urinating, along with fever and the urge to urinate frequently. Cystitis is common in women in the 20-50 age group, and among sexually active women.
  1. Pyelonephritis or kidney infection: Bacteria can also travel from your bladder to the ureters, where it can infect either one or both the kidneys. It is one of the serious medical complications that can be life-threatening to you and your baby. Pyelonephritis increases the risk of preterm labor or having a low birth weight baby, and is associated with an increased risk of fetal or newborn mortality.
  1. Asymptomatic bacteriuria: This is a bacterial infection of the urinary tract, but shows no symptoms. In most cases, it gets resolved on its own, but sometimes it needs treatment. When left untreated, it can put you at a higher risk of contracting acute kidney or bladder infections (5).

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Why Are UTIs Common During Pregnancy?

Urinary tract infections are more common during pregnancy because the growing fetus puts pressure on the bladder and blocks the drainage of urine, allowing bacterial growth.

Hormones can also lead to urinary tract changes, which increase the risk of contracting infections.

Next, we learn about the symptoms and signs that help us identify UTI.

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What Are The Signs And Symptoms Of UTIs During Pregnancy?

In the case of asymptomatic UTIs, you will not experience any symptoms, and your doctor can screen this condition during your prenatal screenings. But if you have symptomatic UTIs, you will notice the following signs and symptoms (6):

  • Pain and burning sensation while urinating
  • Pain or cramps in the lower abdomen
  • Bloody or mucus-filled urine
  • Cloudy or foul-smelling urine
  • Pain or discomfort during sex
  • Tenderness and pain in the bladder
  • Frequent urge to urinate
  • Fever, chills, and sweats
  • Nausea and vomiting
  • Back pain

The doctor may also suggest a few tests to diagnose the presence of infection.

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How Is UTI Diagnosed?

To detect UTI, your healthcare provider will perform the following tests (7).

  • Urine analysis: A urine sample is collected and sent for lab tests to detect red blood cells, white blood cells and bacteria. To avoid contamination of the sample, you have to clean your genital area using an antiseptic before collecting the urine.
  • Urine culture: This is sometimes performed after urine analysis. It uses the urine sample and allows bacterial growth in the lab to check which bacteria is causing the UTI. Accordingly, medications are prescribed.
  • Cystogram: It involves taking an X-ray of the urinary tract to detect problems such as kidney stones and swelling.
  • Cystoscopic exam: Involves inserting a small tube into the urethra to check for urethra and bladder abnormalities.

If the diagnosis is positive for UTI, the doctor will prescribe a course of treatment.

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What Is The Treatment For UTIs During Pregnancy?

The standard treatment for UTIs is the prescription of oral antibiotics for a duration of three to seven days. Though the symptoms go away in three days, you should continue taking the medication as per the course.

Commonly prescribed antibiotics include erythromycin, amoxicillin, and penicillin. These are safe to use as they are assigned to category A by the US Food and Drug Administration (FDA) (8).

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How To Treat A UTI During Pregnancy Without Antibiotics?

Though antibiotics are the standard treatment option for UTIs, you can incorporate some home remedies to reduce the infection (9).

  1. Cranberries: Cranberries and lingonberries reduce the chances of UTI as they prevent the E.coli bacteria from attaching to the walls of the bladder or urinary tract. You might take cranberry juice, dried cranberries or its supplements. Avoid them if you are on blood thinning medications or NSAIDs.
  1. Drink more water: The more water you take, the more you urinate and flush away the harmful bacteria.
  1. Include Greek yogurt and other probiotics: Probiotics improve your gut health and are also useful in treating UTIs. They restore the good bacteria and lower the infection symptoms.
  1. Garlic: Garlic is a powerful antioxidant, immune system booster and anti-inflammatory agent, which makes it effective in fighting UTIs.
  1. Apple cider vinegar (ACV): ACV makes the urine acidic, thereby stopping the bacterial growth and making it easier to flush the bacteria from the bladder. However, it should not be used for long-term therapy as the acidic nature of vinegar can damage the teeth enamel.
  1. Consume more vitamin C: Vitamin C boosts the immune system, and aids in fighting the infection. Include oranges, lemons, berries, apricots, bell pepper, tomato and more in your diet.
  1. Coconut water and milk: When consumed every day, coconut water, which is rich in electrolytes, can aid the treatment. Also, coconut milk has laxative properties with similar benefits.

You may also take a few precautionary measures.

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How Can You Prevent UTIs During Pregnancy?

While there is no sure shot way of preventing urinary tract infections during pregnancy, a little care will lower your chances of contracting them. Here are a few things you should remember to keep away the bacteria causing UTI (10):

  • Do not hold back your urine, and urinate whenever you feel the urge to.
  • After passing stools, clean the area by wiping with a paper towel, from front to back to prevent bacteria from entering the urethra.
  • Clean your genital area with mild soap and water, and keep it dry all the time.
  • Clean the genitals before and after sex.
  • Do not remain in the bathtub for more than half an hour, and more than twice a day.
  • Avoid strong and heavily scented hygiene products as they can cause irritation in the genital region and initiate bacterial growth.
  • Avoid processed and sugary foods such as sugars and spices as they can trigger bacterial growth.
  • Avoid tight-fitting pants and bottoms. Wear loose, cotton pants or bottoms instead.

Next, we answer a few common questions about UTIs.

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Frequently Asked Questions:

1. Can UTI affect pregnancy?

If UTI persists for a long time or recurs frequently, then there is a chance it might affect your ability to conceive and prevent pregnancy. This is because it affects the upper tract including the kidneys, uterus and fallopian tubes.

2. Can a UTI affect a pregnancy test?

Yes, UTI will affect the results of the pregnancy test. It can change the rest result to false positive, due to the presence of red or white blood cells in the urine.

3. Can a urinary tract infection be a sign of pregnancy?

Frequent urination is usually a sign of early pregnancy when the hormonal levels start to change, and the uterus starts to grow. But if the urination becomes painful, it could be due to a urinary tract infection.

4. Can early pregnancy cause UTI?

Early pregnancy will not cause UTI, but you are likely to get UTI in the early stages of pregnancy, after week six.

5. How will UTI affect my baby?

UTIs do not harm the developing baby, but if the infection is left untreated, it will lead to kidney infection. This can result in low birth weight babies and preterm labor. It is understood that early and prompt treatment of UTI will not cause any harm to the baby.

6. Can you develop recurrent UTIs during pregnancy?

Yes, recurrent UTIs are common in pregnant women. Chronic UTI may cause severe pregnancy outcomes including pre-term labor and low birth weight babies (12).

7. Can you take Keflex for UTI in pregnancy?

Keflex belongs to a group of cephalosporin antibiotics which fight bacteria in the body. Your doctor may suggest it to treat UTI, as it falls under the category B pregnancy medications that are not likely to harm the baby (13).

8. Is Macrobid effective against UTI during pregnancy?

Macrobid (nitrofurantoin) is an antibiotic that fights against bacteria, and, is used to treat UTIs. It also falls under category B medication and is safe to use during pregnancy (14).

While UTI is treatable, it is best to try and prevent it by following basic personal hygiene. This way you can avoid unnecessary trouble and medications during this time.

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Have any tips to deal with urinary tract infections during pregnancy? Tell us about it in the comments section below.