Urinary Tract and Kidney Infections

Urinary Tract and Kidney Infections in Pregnancy

A urinary tract infection (UTI) is a
very common health problem of pregnancy. A UTI can cause serious problems in pregnancy
if
it’s not treated. Normal urine is sterile. It has fluids, salts, and waste products.
It
doesn’t have bacteria, viruses, or fungi. The tissues of the bladder are kept apart
from
urine and toxic substances by a coating. This coating helps prevent bacteria from
attaching
and growing on the bladder wall.

The main parts of the urinary tract are:

  • Two kidneys. Purplish-brown organs that sit below the
    ribs toward the middle of the back.

  • Two ureters. Narrow tubes that carry urine from the
    kidneys to the bladder.

  • Bladder. A triangle-shaped, hollow organ in the lower
    belly.

  • Two sphincter muscles. Circular muscles that help keep
    urine from leaking. They do this by closing tightly like a rubber band around the
    opening of the bladder.

  • Urethra. The tube that allows urine to pass from the
    bladder to outside the body.

Types of infections

During pregnancy, normal changes
happen in the way the urinary tract works. One change is that the kidneys grow larger.
The growing uterus can also squeeze the ureters and bladder. During pregnancy, the
bladder does not empty as well. The urine is not as acidic. It contains more sugars,
protein, and hormones. All of these factors can increase the risk for a UTI.

  • Asymptomatic bacteriuria. This infection has no
    symptoms. It’s often caused by bacteria that is in the woman’s system before
    pregnancy. This type of infection happens in about 1 in 20 to 1 in 10 pregnant
    women. It may lead to acute bladder infection or kidney infection if left
    untreated.

  • Acute urethritis or cystitis. A urethral or bladder
    infection. This causes symptoms including pain or burning with urination, frequent
    urination, urgent need to urinate, and fever.

  • Pyelonephritis. A kidney infection. Symptoms may
    include those of acute cystitis plus back pain. It may lead to preterm labor,
    severe infection, and adult respiratory distress syndrome.

The most common bacteria that
causes UTI is E. coli (Escherichia coli). It’s normally found in the vagina and rectal
area. Other bacteria may also cause UTI. These include group B streptococcus and
sexually transmitted gonorrhea and chlamydia.

To diagnose a UTI, your healthcare
provider will take a full health history and give you a physical exam. You will also
need urine testing and a culture for bacteria. Experts advise getting tested at the
first prenatal visit and during pregnancy.

Treatment is important to prevent
serious complications. You may need to take antibiotics. Women with pyelonephritis
in
pregnancy often need to stay in the hospital to get IV (intravenous) antibiotics.