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Pregnancy | Body Matters

I think I have UTI and I’m pregnant!

Don’t stress – you’re not alone. According to the American Urological Association (AUA), 40% of women will experience a urinary tract infection (UTI) at least once in their lifetime. In fact, says the University of Maryland Medical Centre, after the common cold and flu, urinary tract infections are the most common complaint amongst women. So while UTIs may sound scary, they’re really quite treatable. Here’s what you need to know about managing urinary tract infections

What is a urinary tract infection?

As the name suggests, it’s an infection of the urinary tract – occurring anywhere along its length – which aggravates and inflames the lining of the urinary tract, causing pain and discomfort. Medicine distinguishes between cystitis (lower urinary tract infection) and pyelonephritis (upper urinary tract infection). Urinary tract infections are not uncommon in pregnant women, with pyelonephritis – the most common UTI complication – occurring in approximately 2% of all pregnancies, writes Dr Emilie Katherine Johnson* in Medscape.

What is the urinary tract?

Explains the AUA, the urinary tract makes and stores urine. The entire urinary tract comprises the kidneys, the bladder and interconnecting tubes – the ureters, which connect the kidneys to the bladder, and the urethra, the ‘outlet’, running from the bladder to an orifice just above the vagina. In physiology, the distinction is made between the lower urinary tract – comprising the urethra and bladder – and the upper urinary tract, comprising the kidneys and ureters.

What are the symptoms of urinary tract infection?

Symptoms depend on the severity of infection and include:

  • A tender belly
  • A sensation of the bladder being full, and feeling the need to urinate frequently, but only a trickle of urine upon trying to empty it
  • A burning sensation when urinating
  • Cloudy or foul-smelling urine
  • Pain under your ribs and towards the back (i.e. in the kidneys)
  • Pain during sex
  • Nausea
  • Fever or chills
  • Vomiting.
Urinary Tract Infections in Pregnancy

Your doctor will take a urine sample and test it for bacteria

What causes urinary tract infections?

Under normal conditions, urine is sterile. The chief cause of urinary tract infections is E.coli bacteria. Found in the bowels and on our skin, E.coli can make its way into the urethra, travel up to the bladder and on to the kidneys. Structural abnormalities predispose some people to such infections – one of the more common being a condition called vesicoureteric reflux (VUR). In VUR, the manner in which the ureters are joined to the bladder facilitates the flow of urine back towards the kidneys, increasing the risk of bacteria invading the urinary tract. Since our urethras are shorter than those in men, women are at a greater risk of urinary tract infections; the bacteria having a shorter distance to travel to reach the bladder. Other factors predisposing women to urinary tract infections include using a diaphragm or spermicide, diabetes or obstruction of the bladder, for example during pregnancy.

Urinary tract infection and pregnancy

The causes of urinary tract infections in pregnancy are no different – E.coli invading the urinary tract is the chief culprit. An enlarged uterus can increase the chance of bacterial infection, however – as it presses against the urinary passages, partially blocking them, the bladder can be prevented from emptying completely. Constipation – another common complaint of pregnancy – can also be a contributing factor.

How to treat urinary tract infections

Generally, urinary tract infections clear spontaneously after a few days. A severe urinary tract infection, though, can cause complications like blood poisoning or kidney failure. A course of antibiotics should, however, clear the infection in three to five days.

It’s better for pregnant women to be safe than sorry, so if you suspect you have a urinary tract infection, see your doctor as soon as possible. S/he will take a urine sample and test it to see what bacteria are present. Appropriate medication – safe for you and your baby – will be prescribed. Remember, as long as it’s treated early by your doctor, there’s little cause for alarm.

Preventing urinary tract infections in pregnant women

If you struggle with recurrent urinary tract infections, try these tips:

  • After urinating, wipe from front to back to prevent spreading E.coli bacteria towards the opening of the urethra
  • Wash your hands before and after going to the toilet
  • When washing the entrance to the urethra, do not rub – rather wipe gently with a clean, fresh cloth or antiseptic wipe. Avoid over-washing this area since this can remove the body’s natural protection barriers (for example, mucus).
  • When bathing, don’t use bubble baths or other bath additives – they can irritate the skin
  • Avoid fragranced soaps – nothing beats baby soap!
  • Wear loose clothing and cotton underwear – pack away those pantyhose and skinny jeans!
  • Don’t sit cross-legged
  • Up your Vitamin C intake
  • Drink plenty of water
  • Eliminate coffee, spicy foods, chocolate and cola drinks
  • When taking medication, always follow your doctor’s instructions.

*Dr Emilie Katherine Johnson is a Resident Physician at the Department of Urology at the University of Michigan Medical School.

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