Dealing with a UTI in pregnancy
One of the reasons your doctor or midwife is continually checking your urine for proteins during antenatal checkups is to be sure you don’t have a Urinary Tract Infection (UTI). Urinary infections in pregnancy are generally caused by changes in hormones which, in turn, alter the urinary tract. Here we look at why they occur, the symptoms how you will be treated if you should contract a UTI.
What causes a UTI?
The vast majority of UTIs are caused when E-Coli, a type of bacteria that lives in the intestines of many humans and animals, travels from the vagina or rectum and migrates upwards through the urethra. Other less common causes of UTIs are Klebsiella pneumoniae, Proteus bacteria, and Staphylococcus.
It’s possible to have a UTI affecting one or all sections of the urinary tract, from the kidneys, to the ureters to the bladder to the urethra.
Types of UTI and their symptoms
Cystitis: Cystitis is characterised by inflammation and infection of the bladder. According to the NHS typical symptoms of cystitis include:
- Pain, burning or stinging when urinating
- Persistent need to urinate
- Dark, cloudy or strong smelling urine
- Lower abdominal pain
- Feeling of fatigue, sickness or general malaise
Pyelonephritis (kidney infection): The pregnancy hormone progesterone can reduce the effectiveness of the body’s natural drainage ducts, and a growing uterus can also press on the bladder, both can causing urine to remain stagnant in the bladder and to travel up to the kidneys. If left untreated pyelonephritis can result in preterm labour, low-birth-weight baby, and may even contribute to increased foetal or newborn mortality. If you experience any of the following symptoms you should contact your doctor:
- Increased need to urinate
- Urgent need to urinate
- Pain when urinating
- Spotting (light vaginal bleeding)
- Blood in the urine
Asymptomatic bacteriuria: This type of UTI is characterised by the presence of bacteria without any symptoms. Most non-pregnant women with asymptomatic bacteriuria will not experience any health problems and the infection will clear naturally. However, even asymptomatic bacteriuria may harm an unborn child. This is why it is important that your healthcare practitioner regularly tests you as a matter of routine during the course of your pregnancy.
Whether you are 5 weeks, 13 weeks or 38 weeks pregnant, it is possible that you might develop a UTI. In fact, around five percent of all women experience a UTI during pregnancy, with up to half of these suffering from acute pyelonephritis.
In addition to the above listed symptoms you should be watch out for, and contact your health provider in the event of, any of the following:
- Nausea or vomiting
- Unexplained fever
- Pain in the back, abdomen, pelvis or sides
- shaking and shivering
What to do if you get a UTI
If there are reasonable grounds to believe you might have a UTI during pregnancy your GP will test your urine and, if certain bacteria show up, will prescribe you a course of antibiotics; these will be safe for you and your unborn child. Once you are taking the medication, symptoms should subside after three days or so. However, it’s important that you finish the course as prescribed.
In cases of the most acute infection, it may be necessary to receive a course of intravenous antibiotics and you may need to go into hospital for a short while.
Preventing UTIs during pregnancy
Although there is no foolproof way to guarantee that you will not develop a UTI during pregnancy, it is possible to reduce the chances of infection by following a few simple steps. These include the following:
- Stay well hydrated by drinking plenty of water and even consider adding a squeeze of lemon to your water as its acidity will help inhibit the growth of harmful bacteria.
- Avoid sugary foodstuffs, particularly sugary drinks
- Reduce or eliminate your consumption of caffeinated drinks such as tea and coffee
- Eat a wide and balanced diet which is rich in fruit, vegetables, whole grains and antioxidants
- Try not to sit with your legs crossed
- Ensure good hygiene – preferably, take showers rather than baths – and avoid the use of strong soaps and feminine hygiene products on and around your vaginal area
- Urinate regularly and do not hold urine in for any length of time
- Remember to always wipe from front to back after using the toilet
- Wash your genitals before and after any form of sex (and make sure your partner is keeping clean as well
- Wear breathable, soft cotton underwear
- Wear comfortable, loose-fitting pants, skirts and dresses
Cranberry juices and D-mannose supplement
At some point you will probably be recommended cranberry juice in order to help treat a UTI and for general urinary health during pregnancy.
Although there may be some efficacy in the use of cranberry juice to fight a UTI, the truth is that drinking it may actually be counterproductive. This is because most cranberry juices contain large amounts of fructose sugar and only limited amounts of the active ingredient, D-mannose.
D-mannose works by preventing E.coli bacteria from sticking to the walls of the urinary system and has been clinically proven to be safe for use during pregnancy. However, it only works when combating E.coli (responsible for around 90% of UTIs) so has no efficacy when the UTI is caused by another pathogen.
It is possible to purchase D-mannose in powdered form and anecdotal evidence suggests, when taken as directed by a pharmacist or healthcare professional, it may help in the prevention and treatment of UTIs in pregnancy. However, whether you at week 13 or 30 in your pregnancy, you must always discuss the health risks of any supplement or medication with your GP or midwife before taking it.
For expert information on the topic, read Dr Matthew Holmes’ article Urinary tract infection and asymptomatic bacteriuria in pregnancy.