Urinary Tract Infection During Pregnancy

Causes, Symptoms, Treatment, Complications, and Prevention

Urine test
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Urinary tract infections (UTI’s) are common during pregnancy. A UTI may not have any symptoms, but it may show up as a burning sensation during urination or the feeling of having to go again right away. Doctors routinely check for urinary tract infections during prenatal visits and treat them as soon as possible. Here’s what you need to know about the causes, treatment, and prevention of UTI’s during pregnancy.

What Is a UTI?

A urinary tract infection is a medical condition where bacteria from outside the body gets into the urinary system. It can cause a few types of infections:

Your doctor will treat you if she finds any bacteria in your urine, even if you do not have symptoms. 

Risk During Pregnancy

In general, women are more likely than men to get a UTI because of the difference in anatomy. On a woman’s body, the entrance of the urinary tract and bladder (urethra) is only a short distance away from the opening of the colon and gastrointestinal tract (anus). Since bacteria from the intestinal tract can easily move over to the urinary system, it can increase the chance of getting an infection.

When you add pregnancy, the chances of developing a UTI are even greater.

During pregnancy, the growing uterus puts pressure on the bladder. The urethra widens, and under the influence of the hormone progesterone, it loses some of its tone or strength. Plus, it can be more difficult to empty the bladder completely.

All of these pregnancy-related changes increase the risk of microorganisms getting into the urinary tract and causing an infection.

Up to 10 percent of women will get a urinary tract infection during pregnancy, and some women will get more than one.

Symptoms

You can have bacteria in your urine without any symptoms. So, you may not even know you have an infection. However, some of the noticeable signs of a UTI are: 

  • Feeling the need to pee very frequently
  • Feeling as though you cannot fully empty your bladder
  • Difficulty starting the flow of urine
  • Burning or painful urination
  • Tenderness in the pubic area
  • A backache
  • Smelly urine
  • Bloody or cloudy urine
  • Fever

Some of the symptoms of pregnancy such as the urge to pee more often and getting up to urinate during the night are similar to some of the typical symptoms of a UTI. Therefore, it may be hard to tell if what you're experiencing is due to your pregnancy or an infection. That's why it's important to let your doctor know about all your symptoms and any changes that you notice. 

Causes

E.coli is a bacteria from the colon. It is responsible for up to 90 percent of all UTI’s. Although less common, other types of bacteria that can cause urinary tract infections include:

Your risk of getting a UTI also goes up if you have:

  • An STD such as chlamydia, gonorrhea, or herpes 

Diagnosis and Testing

At your first prenatal visit, the doctor will send a urine culture to the lab to check for an infection. At each prenatal visit after that, your doctor will talk to you and perform a routine check-up. Your doctor will: 

  • Ask you if you have any symptoms
  • Perform a physical exam to check for pain or tenderness
  • Check your urine if you have symptoms

If the doctor suspects an infection, she will send your urine for: 

  • A urinalysis: A urine test to check for infection by looking under a microscope for the presence of bacteria.  
  • A urine culture and sensitivity: A test to see which type of bacteria is causing the infection and which medicine can treat it. 

Treatment

During pregnancy, your doctor will treat a UTI right away. Doctors will even treat asymptomatic bacteriuria during pregnancy because it has as much as a 40 percent chance of becoming a UTI or a more dangerous kidney infection. Here is what you can do to treat a urinary tract infection. 

  • Take your medication. For asymptomatic bacteriuria or a minor case of cystitis, your doctor will prescribe an antibiotic. You will take a course of antibiotics for anywhere from 5 – 14 days depending on the antibiotic and type of bacteria that is causing your infection. It’s important to take the medicine as the doctor orders and for as long as the doctor orders. Even if you begin to feel better in a few days, you should not stop the antibiotic. If you stop taking your medication before the entire course of treatment is over, the bacteria could grow back.
  • Drink plenty of fluids. Fluids keep you hydrated and help to flush the bacteria from your body. 
  • Have a glass of cranberry juice. While studies show that drinking cranberry juice does not help UTI’s the way it was once thought it did, it still doesn’t hurt to try it. You just want to be sure it’s 100 percent cranberry juice and not a sugary fruit blend. 
  • Watch what you eat and drink. Try to limit or avoid soda, sweets, and treats. Germs love sugar, and it's the perfect environment for them to grow. So, by removing as much as you can from your diet, you can help prevent further growth of the bacteria.   
  • Use mild soap. Stay away from harsh soaps, powder, and bubble bath.
  • Avoid douching. Do not use a douche to try to clean out the bacteria. Douching changes the normal balance of healthy and unhealthy bacteria in the vagina and can make things worse.

Prevention

If you are worried about getting a urinary tract infection, or if you’ve already had one and do not want it to come back, there are a few things you can do. Here are the steps you can take to try to prevent a UTI.  

  • Wash your hands before and after you go to the bathroom.
  • Drink at least eight glasses of water or other fluid each day to stay hydrated.
  • Empty your bladder very often during the day. If you hold in your urine, it sits in your bladder giving bacteria time to grow and multiply. 
  • Empty your bladder after sex to clear out any bacteria that has moved into your urethra.
  • Wear cotton underpants and change them at least every day to keep the area clean. 
  • Do not wear tight pants or undergarments.
  • Choose to shower over taking a bath. If you do bathe, avoid bubble baths or long baths. 
  • Go to all your prenatal appointments to get checked for a UTI that may not have any symptoms.
  • If you have to take antibiotics during your pregnancy, you can eat yogurt with active cultures or talk to your doctor about using probiotics. Yogurt and probiotics can help keep your body’s bacteria in balance. 
  • Eat well, get enough rest and try not to become too fatigued or stressed. Exhaustion and stress can affect your immune system and lower your resistance to infection. 
  • Learn how to recognize the symptoms of a UTI so you can report them to your doctor and get treatment right away if you develop one.

Complications

Most of the time a UTI is not serious, and your doctor can treat it successfully with a course of antibiotics. However, in some rare cases, an untreated UTI can cause complications during pregnancy. 

An untreated UTI can lead to pyelonephritis. A kidney infection is more dangerous than a bladder infection or asymptomatic bacteriuria. The symptoms of a kidney infection are similar to the symptoms of a UTI but may also include:

  • Fever
  • Chills
  • A backache or pain on the sides of the body (where the kidneys are)
  • Nausea and vomiting
  • Blood in the urine

Depending on the severity, a doctor may treat a kidney infection in the hospital. The treatment includes: 

  • Bed rest
  • Intravenous (IV) antibiotics
  • IV fluids for hydration
  • Medication to reduce fever (antipyretics)
  • Pain medicine
  • Monitoring

If a kidney infection is not treated and becomes severe, it could lead to issues for mothers such as:

It can also affect the baby by leading to:

A Word From Verywell

A urinary tract infection is a common pregnancy condition. It may be a little painful or annoying, but a typical, uncomplicated UTI is usually not dangerous. You will have to take medicine, but your doctor will prescribe an antibiotic that is safe for you and the child you're carrying.  

It is only when a urinary tract infection goes untreated and moves up the urinary tract, that it may become a problem with complications that could affect you and your baby. However, serious complications are rare, and most of the time a UTI is just a minor issue.

Sources: 

Bienstock JL, Fox HE, Wallach EE, Johnson CT, Hallock JL. Johns Hopkins Manual of Gynecology and Obstetrics. Lippincott Williams & Wilkins; 2015 Mar 23.

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Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M. State of the art paper Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Archives of Medical Science. 2015 Jan 1;11(1):67-77. doi: 10.5114%2Faoms.2013.39202

Mazor-Dray E, Levy A, Schlaeffer F, Sheiner E. Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome?. The Journal of maternal-fetal & neonatal medicine. 2009 Jan 1;22(2):124-8. doi: 10.1080/14767050802488246

Vasudevan R. Urinary tract infection: an overview of the infection and the associated risk factors. J Microbiol Exp. 2014;1(2):1-5.