What causes Urinary Tract Infection during pregnancy?

By Dr Madhushree Vijaykumar

A Urinary Tract Infection (UTI) is a bacterial infection that can result on any part of the urinary tract like the bladder, the urethra and sometimes even the kidneys. UTIs are quite common, more so in women than in men. Women can often suffer from UTI during pregnancy as well, and if left undetected or untreated, it may cause some serious problems for the mother and the baby.

What causes UTI during pregnancy?

Pregnant women are more susceptible to UTIs as their immune system is already weak. In addition, the growing foetus puts pressure on the bladder and urinary tract; this traps the bacteria causing the UTI and leads to urine leakage.

The physical changes during pregnancy are also a major cause. After six weeks of gestation, the urethra expands and continues to do so until delivery. The large urinary tract, combined with increased volume of the bladder, cause the urine to remain still in the urethra which leads to the growth of bacteria causing infection.

The hormonal changes pregnant women undergo can also cause UTI. The urine during pregnancy contains more proteins, sugars and hormones and is less acidic. This increases the risk of UTI. If the expectant mother is also suffering from anaemia, she would be more prone to UTI. Lack of haemoglobin results in the tissues not being oxygenated well, so even the harmless organisms entering may lead to infection.

A retroverted uterus, where the uterus curves in a backward position at the cervix instead of forward (the uterus is tilted at a wrong angle) will also lead to recurring UTI among pregnant women. Pregnant women with gestational diabetes, where the cells use insulin less effectively and there is an increase in the blood glucose level, are also prone to UTI. Apart from the bodily changes due to pregnancy, lack of proper hydration is also a common cause for UTI.

Types of UTI

Symptomatic UTI: As the name suggests, there is a presence of symptoms in this type of UTI. They may include frequent urination, burning/stinging during urination, strong-smelling urine, urine that appears red or pink (due to presence of blood), feverishness, pelvic pain etc.

Asymptomatic UTI: Here the patients do not show any of the usual symptoms of UTI. Asymptomatic UTI is particularly dangerous for pregnant women as it can progress upward and cause acute urethritis (inflamed and irritated urethra), acute cystitis (inflammation of the bladder) and acute pyelonephritis (bacterial infection of the kidneys). If left untreated asymptomatic UTI can cause severe health risks for the mother and the baby.

Early detection of UTI during pregnancy, a crucial thing

UTIs can cause serious health risks, especially if asymptomatic, as they have a higher risk of going unnoticed. Therefore, it is highly important that women get their urine sample checked every three months or so. Some repercussions of leaving UTI untreated can be: pre-term deliveries, low birth weight babies, anaemia, significant UTI that has extended to the kidneys, for example, may lead to premature leakage and rupture of membranes. The infection could also spread to the child. There is an increase in the risk of perinatal mortality.

Treatment for pregnant women suffering from UTI

Each woman and her pregnancy-related issues are different; therefore, doctors have to decide what treatment is suitable for relieving the urinary tract infection on a case-to-case basis. Most UTIs can be treated with a course of antibiotics. The doctors do a urine culture test for the first 48 hours and if the culture is positive for UTI, then the mother is given suitable antibiotics.

If there are no signs of infection in the first 48 hours, the culture is observed for the next 72 hours, even after this, if the culture is clear, the normal fluid intake will be sufficient to prevent further UTI.

What steps can you take to prevent UTI during pregnancy?

Though there is no way to guarantee that you will not suffer UTI during your pregnancy, some measures can be taken to decrease the risk of occurrence like:

⦁ Stay Hydrated: Drink plenty of water and plenty of fluids, this is an effective way of getting rid of germs from your urinary tract
⦁ Practice good hygiene: To prevent the spread of bacteria practicing good hygiene is of utmost importance.
⦁ Eat a balanced diet: Consume food, which is good for your body. You need to make sure that you avoid food substances that can irritate the bladder and inflame it. Caffeine and chocolates are some of the culprits that can cause this.
⦁ Urinate frequently: You need to pass the urine when you get the urge immediately, make sure that you empty your bladder completely, so no urine is leftover leading to bacterial growth in the urinary tract.

Pregnancy is an overwhelming condition to deal with and it is thus imperative to stay alert and vigilant. One must consult the gynaecologist almost immediately even with the slightest hint of suspicion. Timely urine test can rule out UTI in pregnancy to avoid any further complication.

(Dr Madhushree Vijaykumar is a Consultant Obstetrician and a Gynaecologist)