As you adjust to new changes in your body during pregnancy, it can be easy to overlook symptoms of everyday health conditions, such as urinary tract infections (UTIs). UTIs are equally common in pregnant and non-pregnant patients and usually require medication to clear the infection.
But if left untreated during pregnancy, a UTI can progress to a serious infection that can lead to preterm labor, premature delivery, or even fetal loss.
UTIs occur when bacteria enter and grow in the urinary tract. During pregnancy, your bladder – which is in the lower part of your urinary tract – is less likely to empty entirely when you urinate, thanks to pressure from your expanding uterus and an increase in hormones that relax the muscles in your uterus. The longer urine stays in your body, the higher the chances that you’ll grow too much bacteria.
We watch for three types of UTIs during pregnancy:
- Asymptomatic: Approximately 7% of pregnant women may have a UTI that doesn’t cause symptoms. An untreated asymptomatic infection has a 25% chance of advancing to the next level of UTI – your bladder and then your kidney.
- Cystitis: Localized to the bladder, this infection will cause symptoms typically associated with UTIs, such as frequent but small amounts of urine, painful urination, and strong urges to urinate immediately.
- Pyelonephritis: This kidney infection can lead to serious issues such as septic shock, anemia, excess lung fluid, and pre-term labor. It typically includes the symptoms of cystitis, plus nausea, fever, chills, and pain in your lower back and sides.
Because UTIs are prevalent during pregnancy, we request a urine sample to conduct a culture test as part of your prenatal care. The test looks for specific types of bacteria in your urine that can cause an infection.
We will likely test your urine multiple times throughout your pregnancy. But don’t assume we’re looking for a UTI every time; this is a common misconception. It’s important to talk with your doctor if you experience UTI symptoms to make sure you get the right test. The earlier we diagnose a UTI, the sooner we can treat you and prevent a more dangerous condition.
UTI treatment: What to expect
UTI treatments during pregnancy are safe and easy, usually involving a short course (3-7 days) of oral antibiotics. There are two exceptions:
- If you continue to have UTIs after we treat the first one, we may recommend suppressive therapy. You will take a lower dose of antibiotics every day of your pregnancy instead of larger doses for just a few days.
- If you have pyelonephritis (kidney infection), you will need to receive antibiotics through an IV at a hospital.
For most patients, receiving antibiotic treatment is much safer than risking a kidney infection. We will discuss all your health conditions and pregnancy symptoms to determine the best type of antibiotic for you, depending on what will work effectively against the bacteria in your urine.
Not all urine tests are the same
In the third trimester, we’ll likely test your urine for the presence of protein or glucose, which can indicate high blood pressure or gestational diabetes. Around this time, we also test urine for sexually transmittable diseases such as chlamydia and gonorrhea, which can be transferred to your baby.
Neither of these tests will tell us whether you have a UTI. If you’re experiencing UTI symptoms, please tell us so we can perform the appropriate test and begin treatment.
What increases or reduces risk of UTIs during pregnancy?
Women who have or carry the trait for sickle cell disease are at increased risk for UTIs. We test these patients monthly to ensure we detect an infection as soon as possible.
If you have diabetes, you’re also at a higher risk. We might not test you as frequently, but we will consistently look for symptoms. Both conditions make it harder for the body to fight infections.
Just as when you’re not pregnant, you can take specific actions to lower your chances of getting a UTI, such as:
- Wiping front to back in the bathroom
- Urinating before and after sex
- Wearing cotton underwear
- Avoiding tight and wet clothing
- Drinking more water
Prepare for possible postpartum UTIs
In some cases, the risks of developing a UTI increase after you give birth.
Patients who have a C-section or receive an epidural during labor have a catheter inserted into their bladder. This ensures a safer delivery by keeping your bladder empty. But a catheter increases your risk of infection the longer it stays in your body, and its placement provides the perfect track for bacteria to enter your bladder.
To decrease your UTI risk, our goal is to remove your catheter no more than six to eight hours after surgery and even sooner after an epidural. An infection can take days to appear, so watch for symptoms after you leave the hospital and tell your doctor right away if you experience them. We don’t perform routine UTI tests after delivery, so it’s important to alert us to abnormal pain or discomfort.
With so many new tasks to complete and emotions to experience after bringing your newborn home, it can feel overwhelming to keep track of one more thing – but your health remains a priority after the birth of your baby. The more you tell us about how you feel, the more we can do to help you stay healthy.
To visit with an Ob/Gyn, call 214-645-8300 or request an appointment online.