Urinary tract infections in pregnancy
What is a UTI?
A urinary tract infection (UTI) is caused when the urinary system becomes infected by bacteria. UTIs are much more common in women than in men and even more common in women aged between 20 and 50. About 50 per cent of women will have at least one UTI during their lifetime.
Cystitis, an infection of the bladder, is a common UTI which you’re more likely to develop while you’re pregnant.
If left untreated, UTIs can be quite painful – and even dangerous because the infection can travel upwards and reach the kidneys. If a kidney infection is left untreated during pregnancy it could make you very poorly and could lead to your baby being born with a low birth weight or being born prematurely.
Being pregnant makes you more susceptible to UTIs. Progesterone relaxes the muscles of your ureters, the tubes that connect your kidneys to your bladder. This slows down the flow of wee from your kidneys to your bladder. Your enlarging uterus (womb) has the same effect. This is an ideal opportunity for bacteria because they have more time to grow before they’re flushed out.
Symptoms of a UTI in your bladder (cystitis) may include:
- pain or discomfort in your pelvis, the lower part of your tummy, the lower part of your back, or in your side
- pain or a burning sensation when you wee
- being unable to wee properly
- an uncontrollable urge to wee
- slightly raised temperature
- frequent need to wee
- cloudy, bloody, or bad-smelling wee
- change in the amount of wee you pass (either more or less)
- pain during sex
Signs that the infection has spread to your kidneys may include:
- a high temperature of 38 degrees C or above
- constant pain in your back, pelvis or side
- shaking and shivering
- nausea and vomiting
- feeling hot and cold by turns
I often get urinary tract infections. What happens if I get one while I’m pregnant?
Your doctor will test your urine for the presence of bacteria and will prescribe antibiotics, if appropriate. Antibiotics are effective and most are safe to take if you develop a UTI in pregnancy. You will usually be prescribed a course which will need to be taken for between three days and seven days.
If you have an underlying infection, such as a severe kidney infection (pyelitis), you may be admitted to hospital for intravenous antibiotics. These will give you the dose you need, straight into your body through your vein, to clear up your infection.
If you have repeated UTIs you may need to take a low dose of antibiotics for a longer period of time. You can take paracetamol to relieve your pain and fever when pregnant. But talk to your GP or midwife as soon as you notice any symptoms.
If antibiotics don’t help, you may have an ultrasound scan so the doctor can view your bladder and kidneys.
If you have repeated UTIs that antibiotics don’t clear up, your doctor may recommend a cystoscopy. During this procedure, a urologist places a thin instrument (cystoscope) with a light and a camera at one end through your urethra and into your bladder. Your urologist will use a numbing gel around the opening to your urethra, so the most you will feel is mild discomfort.
What can I do to avoid getting an infection?
Taking the following precautions should reduce your chance of getting a UTI:
- After going to the toilet, wipe yourself from front to back to prevent bacteria from your back passage being spread to your front passage (urethra).
- Wash between your legs every day.
- Don’t use strong soaps, scented bubble baths, shower gels, douches, antiseptic creams or feminine hygiene products. These may destroy the good bacteria and irritate your urinary tract.
- Empty your bladder completely when you go to the toilet.
- Go to the toilet soon after having sex
- Avoid long or very frequent baths and have showers instead.
- Wear cotton knickers and loose clothes, rather than tight jeans and trousers. It’s also best not to wear tights, but if you do wear them, put on clean ones daily.
- Change your underwear every day.
- Treat constipation as soon as possible.
- Drink plenty, especially water.
What you eat or drink, for example spicy food, may make your cystitis worse. Steer clear of these triggers for a while and see if it makes a difference.
You could try drinking cranberry juice if you suffer from repeated UTIs. Cranberry juice may reduce levels of bacteria in the urinary tract, and prevent new bacteria from taking hold.
Studies have found that women who drank cranberry juice, or took cranberry supplements, didn’t have as many recurring infections over the course of a year. The women were given the equivalent of about one or two glasses of cranberry juice every day, either in tablet or liquid form.
However a separate study found that cranberry juice had no effect on how many infections women had over the course of six months. So there is still some doubt about its effectiveness.
There’s no evidence that cranberry juice can cure a UTI once the infection has already taken hold.
The good news is that if you are prescribed antibiotics, your symptoms will probably improve after the first day of taking them.