As if your urinary tract weren’t under enough pressure! Here’s why you need to be on guard against urinary tract infections, or UTIs, during pregnancy.
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Your urinary tract is the perfect breeding ground for unwelcome visitors: bacteria. They multiply fast in areas being squished by your expanding uterus. That compression — plus the muscle-relaxing properties of the hormones flooding your body — makes it much easier for the intestinal bacteria that live quietly on your skin and in your feces to enter your urinary tract during pregnancy… and make you miserable. In many cases, you may actually have an infection even though you experience no symptoms at all — and left untreated, UTIs can cause serious problems. Fortunately, this common infection is easily treated, keeping you healthy and a whole lot more comfortable.
WHAT IS A UTI?
The urinary tract, which removes waste and extra water from the body, is made up of two kidneys, where urine is produced; two ureters, which carry urine to your bladder; the bladder itself, which collects and stores the urine; and the urethra, the tube that sends the urine out of your body. In some cases, normal bacteria from your skin and other areas can trespass into areas where they don’t belong, and the urinary tract is one of them.
While most UTIs occur in the bladder (where it’s called acute cystitis, or a bladder infection), they can occur in the urethra (called urethritis). In more serious cases, they can travel up to the kidneys (called acute pyelonephritis or a kidney infection).
CAUSES OF A UTI DURING PREGNANCY
Several factors can lead to a UTI during pregnancy, including:
Changes in your body. All women are at risk for UTIs (even more so than men because, for starters, our urethra is shorter, making it easier for bacteria to enter the bladder). But pregnant women may be even more prone: Changes in hormones may give bacteria an easier opportunity to travel up the urinary tract and cause an infection. Your growing uterus also puts added pressure on your bladder, making it more difficult to completely empty it of urine (which also means women carrying multiplesare even more susceptible to UTIs).
Bacteria from the bowel. UTI-causing bacteria can come from several places. A common bacterial invader, E. coli, comes from the bowel. Because the urethra is located close to the rectum, these bacteria can be transported up the urethra. Wiping from front to back (instead of back to front) every time you use the bathroom can help keep bacteria away from this area.
Intercourse. Sex during pregnancy is perfectly healthy (unless your doctor tells you otherwise) — but there is a downside: It also has the potential to lead to a UTI, as bacteria near the vagina may be pushed into the urethra during intercourse. It may not be romantic, but it’s important to urinate before and after sex to move that bacteria along.
Group B streptococcus. This type of bacteria, commonly carried in the intestinal tract, can also cause UTIs during pregnancy. Late in your pregnancy, your doctor will test you for this infection and treat you with antibiotics if necessary.
There are also some less avoidable risk factors. If any of these apply to you, be sure to discuss them with your doctor so you can be closely monitored for signs of an infection:
A history of recurring UTIs
Maternal diabetes
Sickle cell disease
Kidney disease
Previous urinary tract surgery
UTI SYMPTOMS
Every woman’s body is different, so be sure to tell your doctor about any pain or discomfort you feel — especially if you experience any of these typical UTI symptoms:
Burning sensation during urination
Frequent trips to the bathroom to urinate (though frequent urination alone is a common — and harmless — side effect of pregnancy)
Intense urge to urinate while the amount of urine expelled is small
Cloudy, dark, bloody or foul-smelling urine
Low-grade fever
Lower-abdominal pain or discomfort
Pain that occurs on one side between the upper abdomen and the back or on the back; this could indicate a kidney infection, which should be treated immediately
Chills, nausea and vomiting, which can also be signs of a kidney infection
Keep in mind: It’s been estimated that up to 7 percent of all pregnant women have UTIs with no symptoms at all. Because an untreated infection can lead to complications — including kidney infection and, rarely, an increased risk of fetal growth restriction and preterm birth — the urine tests at your prenatal visits are really important. (Have you scheduled your next appointment yet?)
UTI DIAGNOSIS & TREATMENT
Think you may have a UTI? The standard way to diagnose one (during pregnancy or otherwise) is a urine culture. Most doctors will ask for a “clean catch” sample, where you pee into a cup midstream after carefully wiping your outer vaginal area.
If you are diagnosed with a UTI, your doctor will likely provide apregnancy-safe antibiotic for seven to 14 days to get rid of the bacteria. Be sure to take the recommended full course, even if you start to feel better midway through treatment, and drink plenty of water.
PREVENTING UTIS
While UTIs might happen whatever precautions you take, a few steps can help reduce the odds you’ll suffer from a UTI during pregnancy:
Stay hydrated. Try to drink enough water every day; the increase in bathroom time helps flush bacteria out of the urethra.
Befriend the bathroom. You may feel like you’re waddling to the bathroom every five minutes — but it’s important to never hold in your urine. As soon as you get the urge to go, go. Be sure to completely expel your urine, too (try leaning forward while sitting on the toilet). Before turning in for the night, empty your bladder again.
Wear cotton-crotch underwear. This will help keep that area dry, as bacteria thrive in moisture.
Wipe from front to back. This goes for every bathroom visit.
Avoid feminine hygiene products. Douches or powders can cause irritation to an already vulnerable area.
Eat well. Keep your resistance high by eating a healthy pregnancy diet and staying active. Some practitioners recommend eating yogurt that contains active cultures or taking probiotics if you’re on antibiotics to help restore the balance of beneficial bacteria. Ask your practitioner first, though; some probiotics are definitely more potent than others. While it was once thought that a compound in cranberry juice could help reduce UTI recurrence, experts now say the benefit, if any, is small. So feel free to sip on some of the red stuff if you’re craving it — it will help with hydratation — but don’t chug, since most varieties are also chock-full of refined sugar.
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