A urinary tract infection (UTI), also called bladder infection, is a bacterial inflammation in the urinary tract. Pregnant women are at increased risk for urinary tract infections starting in week 6 through week 24.
Urinary tract infections are more common during pregnancy because of changes in the urinary tract. The uterus sits directly on top of the bladder. As the uterus grows, its increased weight can block the drainage of urine from the bladder, causing an infection.
You can have a urinary tract infection in any part of your urinary tract, which starts at the kidneys, where urine is made; continues through tubes called ureters down to the bladder, where urine accumulates until you pee; and ends with the urethra, a short tube that carries the urine outside your body.
Bacteria from your skin, vagina, or rectum generally cause urinary tract infections, as they enter your urethra and travel upstream. There are several common types of urinary tract infections:
Cystitis or Bladder Infection
Often, bacteria stop in your bladder and multiply there, causing inflammation and triggering those familiar symptoms of a bladder infection. Cystitis is fairly common among sexually active women between the ages of 20 and 50.
Bacteria may also travel from your bladder up through the ureters to infect one or both kidneys. A kidney infection (also called pyelonephritis) is the most common serious medical complication of pregnancy. The infection can spread to your bloodstream and become life-threatening for you. A kidney infection may also have serious consequences for your baby. It increases your risk of preterm labor and having a low birth weight baby, and it has been linked to an increased risk of fetal or newborn mortality.
It is possible to have bacteria in your urinary tract and have no symptoms. This is known as asymptomatic bacteriuria. When you are not pregnant, this condition generally doesn’t cause problems and often clears on its own. During pregnancy, however, asymptomatic bacteriuria that is left untreated significantly increases your risk of getting a kidney infection and is associated with preterm labor and low birth weight. This is one reason your urine is routinely tested during pregnancy. It is not clear that pregnancy increases your risk of cystitis, and there’s a fair amount of research showing that pregnancy does not make you more likely to have asymptomatic bacteriuria. However, pregnancy greatly increases the risk of getting a kidney infection.
Higher levels of the hormone progesterone decrease the muscle tone of the ureters (the tubes between the kidneys and the bladder), causing them to dilate and slowing the flow of urine. Plus, as your uterus enlarges it may compress the ureters, making it that much more difficult for urine to flow through them as quickly and as freely as usual. Your bladder also loses tone during pregnancy. It becomes more difficult to completely empty your bladder, and your bladder becomes more prone to reflux, a condition where some urine flows back up the ureters toward the kidneys.
It takes longer for urine to pass through your urinary tract, giving bacteria more time to multiply and take hold before being flushed out, and it also becomes easier for the bacteria to travel up to your kidneys. During pregnancy your urine becomes less acidic and more likely to contain glucose, both of which boost the potential for bacterial growth.
If you have a urinary tract infection, you may experience one or more of the following symptoms:
- Pain or burning (discomfort) when urinating
- The need to urinate more often than usual
- A feeling of urgency when you urinate
- Blood or mucus in the urine
- Cramps or pain in the lower abdomen
- Pain during sexual intercourse
- Chills, fever, sweats, leaking of urine (incontinence)
- Waking up from sleep to urinate
- Change in amount of urine, either more or less
- Urine that looks cloudy, smells foul or unusually strong
- Pain, pressure, or tenderness in the area of the bladder
- When bacteria spreads to the kidneys you may experience: back pain, chills, fever, nausea, and vomiting.
If the urinary tract infection goes untreated, it may lead to a kidney infection. Kidney infections may cause early labor and low birth weight. If your health care provider treats a urinary tract infection early and properly, the urinary tract infection will not cause harm to your baby.
If you develop a kidney infection during pregnancy, you will be hospitalized and started on intravenous fluid and antibiotics, and you and your baby will be carefully monitored. Your health care providers will be assessing a variety of things, including your temperature, blood pressure, pulse, breathing, and ability to make urine, your baby’s heart rate, and whether you have any signs of premature labor.
The length of hospitalization for a kidney infection varies, depending on your individual situation. If, after an initial 12- to 24-hour assessment, it is clear that you have a mild case, you are responding well to treatment, and preterm labor is not a concern, your health care provider may decide to discharge you from the hospital and switch you to oral antibiotics for the remainder of your treatment.
On the other hand, if you have a severe case, you will need to remain in the hospital for further treatment and monitoring, and you won’t be discharged until 24 to 48 hours after your temperature returns to normal and you no longer have any symptoms.
Once you complete your treatment, you will be put on a regimen of low-dose antibiotics for the remainder of your pregnancy to help prevent another infection. Without daily suppressive therapy, your risk of getting another kidney infection is very high.
A urinalysis and a urine culture can detect a urinary tract infection throughout pregnancy. If you are diagnosed with a urinary tract infection, it can be safely treated with antibiotics during pregnancy. Antibiotics most commonly treat urinary tract infections. Doctors usually prescribe a 3-7 day course of antibiotics that is safe for you and the baby.
Call your health care provider if you have fever, chills, lower stomach pains, nausea, vomiting, and contractions, or if after taking medicine for three days, you still have a burning feeling when you urinate.
You may do everything right and still experience a urinary tract infection, but you can reduce the likelihood by doing the following:
- Drink 6-8 glasses of water each day and unsweetened cranberry juice regularly.
- Eliminate refined foods, fruit juices, caffeine, alcohol, and sugar.
- Take Vitamin C, Beta-carotene, and Zinc to help fight infection.
- Develop a habit of urinating as soon as the need is felt and empty your bladder completely when you urinate.
- Urinate before and after intercourse.
- Avoid intercourse while you are being treated for an UTI.
- After urinating, blot dry (do not rub), and keep your genital area clean. Make sure you wipe from the front toward the back.
- Avoid using strong soaps, douches, antiseptic creams, feminine hygiene sprays, and powders.
- Change underwear and pantyhose every day.
- Avoid wearing tight-fitting pants.
- Wear all cotton or cotton-crotch underwear and pantyhose.
- Don’t soak in the bathtub longer than 30 minutes or more than twice a day.
Although a urinary tract infection during your pregnancy may be scary and concerning at first, if caught early enough there should be no major issues. You can get on with the most important part of your pregnancy: celebrating the new life to come.