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Urinary Tract Infections (UTI) During Pregnancy

Written by WebMD Editorial Contributors

Medically Reviewed by Nivin Todd, MD on September 04, 2022

In this Article

• UTI Symptoms
• Why Are UTIs More Common During Pregnancy?
• UTI Diagnosis
• UTI Treatment During Pregnancy
• UTI Complications During Pregnancy
• UTI Prevention

A urinary tract infection (UTI) is an infection of some part of your body's urinary system, which includes your:

• Kidneys
• Ureters (tubes that carries urine from your kidneys to your bladder)
• Bladder
• Urethra (a short tube that carries urine from your bladder to outside your body)

Bacteria cause most UTIs. Anyone can get one, but they're most common in women, and they can be extra concerning if you're pregnant.

If you think you might have a UTI, tell your doctor. With proper care, you and your baby should be fine.

Usually, these infections are in the bladder and urethra. But sometimes they can lead to kidney infections. If they do, UTIs may lead to preterm labor (giving birth too early) and low birth weight.

UTI Symptoms

If you have a UTI, you may have:

• An urgent need to pee, or peeing more often
• Trouble with peeing
• A burning sensation or cramps in your lower back or lower belly
• A burning feeling when you pee
• Urine that looks cloudy or has an odor
• Blood in your pee, which can turn it red, bright pink, or cola-colored

If you have a kidney infection, you may have:

• Fever
• Nausea
• Vomiting
• Upper back pain, often on just one side

If you have symptoms of a kidney infection, see your doctor right away. Without treatment, the infection can spread into your bloodstream and cause life-threatening conditions.

Why Are UTIs More Common During Pregnancy?

Hormones are one reason. In pregnancy, they cause changes in the urinary tract, and that makes women more likely to get infections. Changes in hormones can also lead to vesicoureteral reflux, a condition in which your pee flows back up from your bladder to your kidneys. This can cause UTIs.

When you’re pregnant, your pee has more sugar, protein, and hormones in it. These changes also put you at higher risk for a UTI.

Because you’re pregnant, your growing uterus presses on your bladder. That makes it hard for you to let out all the urine in your bladder. Leftover urine can be a source of infection.

Other causes of UTIs include:

Escherichia coli and other bacteria from your poop. E. Coli is the most common cause of UTIs and can move from your rectum to your urethra if you don’t wipe from front to back.

Sexual activity. Fingers, your partner’s penis, or devices can move bacteria near your vagina into your urethra.

Group B streptococcus. Many women have this bacteria in their colon and vagina. It can cause UTIs and women can pass it to their newborns. Your doctor will test you for this bacteria around weeks 36 to 37 of pregnancy. If you’re positive for group B strep, your doctor will give you IV antibiotics during labor.

UTI Diagnosis

You’ll take a urine test. Your doctor will test it for bacteria and red and white blood cells. A urine culture may also be checked. It shows what kind of bacteria are in the urine.

UTI Treatment During Pregnancy

You’ll take antibiotics for 3 to 7 days or as your doctor recommends. If your infection makes you feel uncomfortable, your doctor will probably start your treatment before you get your urine test results.

Your symptoms should go away in 3 days. Take all of your medication on schedule anyway. Don’t stop it early, even if your symptoms fade.

Many common antibiotics -- amoxicillin, erythromycin, and penicillin, for example -- are considered safe for pregnant women. Your doctor wouldn’t prescribe others, such as ciprofloxacin (Cipro), sulfamethoxazole, tetracycline, or trimethoprim (Primsol, Proloprim, Trimpex), that can affect your baby’s development.

UTI Complications During Pregnancy

Pyelonephritis is a UTI that affects the kidneys. If you’re pregnant it can cause:

• Preterm labor
• Severe infection
• Adult respiratory distress syndrome
• Anemia
• Long-term infection

UTI Prevention

To try to avoid getting a UTI:

• Drink at least eight glasses of water a day.
• Wipe yourself from front to back when you go to the bathroom.
• Empty your bladder shortly before and after sex.
• If you need a lubricant when you have sex, choose a water-based one.
• Don't douche.
• Avoid strong feminine deodorants or soaps that cause irritation.
• Wash your genital area with warm water before sex.
• Wear cotton underwear.
• Take showers instead of baths.
• Don’t wear pants that are too tight.
• Pee often.
• Avoid alcohol, citrus juices, spicy food, and caffeinated drinks, which can irritate your bladder.

Women's Health Guide

1. Screening & Tests
2. Diet & Exercise
3. Rest & Relaxation
4. Reproductive Health
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Pregnancy and urinary tract infections (UTIs)

Shilov Maxim Vladimirovich

Urologist

December 28, 2015

During pregnancy urinary tract infections (UTIs) are not uncommon. Women turn to urologists both for the first time faced with this situation, and with an exacerbation of a chronic, pre-existing disease.

Pregnant women are more vulnerable to urinary tract infections, as the woman's body experiences a state of physiological immunodeficiency, which makes it more susceptible to various infectious factors. And the urinary system is not least exposed to inflammatory processes, especially if all chronic diseases have not been treated before pregnancy. nine0075

The second moment that affects UTI is the growing "pregnant" uterus, which, as it grows, begins to compress the ureter (more right), thereby causing a violation of the outflow of urine. According to ultrasound in this case, you can see calicopyeloectasia - the expansion of the calyces and pelvis of the kidneys. This is a physiological condition, but it can contribute to the development of infection.

Because your risk of developing a urinary tract infection is higher during pregnancy, you will have periodic urinalysis and cultures to help diagnose possible UTIs early. With what frequency, the gynecologist who observes the pregnancy will tell. If there are changes in urine tests, you will be referred to a urologist, do not be surprised, urologists treat not only men, who will deal with UTIs in the future. nine0075

There are several conditions that characterize UTI during pregnancy:

First: if there are complaints of dysuria (increased painful urination, blood in the urine) or pain in the lumbar region + increased body temperature, and in urine tests - an increased number of leukocytes and/or RBCs is a clear UTI that should be treated with antibiotics.

But there is a second option: nothing bothers you, the general urine test is normal, but there are bacteria in the urine culture (bacteria concentration should be more than 10 * 5 CFU / ml in two crops with an interval of 7-10 days, and both cultures must have the same bacterium) - this condition is called asymptomatic bacteriuria, which also requires antibiotic therapy. nine0075

A very common question: "Why should I take antibiotics if I feel good?"

- Yes, of course, there may be no symptoms of UTI, but the presence of a large titer of bacteria in the urine can further complicate the course of labor and the postpartum period, up to preterm labor and intrauterine infection of the fetus, and also develop into an "obvious" form of UTI already with symptoms!

I would also like to note that one should not be afraid of antibiotics (often women start to worry after the mention of them) and their possible impact on the child. There is a certain list of acceptable antibacterial drugs in different trimesters of pregnancy! nine0075

In the first trimester, use of: protected penicillins (Ampicillin, Amoxicillin/clavulonate, Amoxicillin/sulbactam), Fosfomycin trometalol (Monural) (can be used in all trimesters), macrolides (Josamycin, Azithromycin). In the second and third trimester: third-generation cephalosporins (Cefixime, Ceftriaxone, Cefotaxime, Ceftazidime) are added to the first list. But remember that taking certain drugs, and especially during pregnancy, should only be prescribed by a doctor. nine0075

In addition to antibiotics, herbal uroantiseptics (Phytolysin, Canephron, Cyston, etc.) are often prescribed during pregnancy as maintenance therapy along with antibacterial drugs. Quite often, gynecologists prescribe them as a prophylactic, sometimes for the entire duration of pregnancy. But they should not be abused, and even more so taken on their own without a doctor's recommendation, since they can contribute to the formation of oxalate stones with long-term continuous use, especially if there are already violations of mineral metabolism, as they sometimes say, "sand" in the kidneys by ultrasound. They should be taken in courses with interruptions, the duration of the course is determined only by the doctor! nine0075

Unfortunately, sometimes conventional antibiotic therapy is not effective (especially in chronic processes) and one has to resort to invasive techniques, such as cystoscopy followed by instillations into the bladder. Cystoscopy, as well as instillations into the bladder, are carried out only according to strict indications, only in cases where they really cannot be dispensed with! But sometimes you have to resort to these methods during pregnancy, so you should not be surprised if the doctor prescribes the above studies and procedures for you. nine0075

Finally, I would like to tell you about such a condition as Calicopyeloectasia during pregnancy . As mentioned earlier, calicopyeloectasia is a physiological condition during pregnancy, but it happens that against the background of an expanded pyelocaliceal system (PCS) of the kidney, a bacterial infection joins (especially with chronic pyelonephritis and cystitis poorly treated before pregnancy).

In such conditions as: the presence of chronic pyelonephritis in the active phase + expansion of the PCS, as well as pain syndrome (for example, caused by an acute infectious process or renal colic (migration of a stone along the urinary tract) - kidney stenting is performed.

A stent is a specially designed tube made of a flexible plastic material that fits into the ureter, allowing what is known as "closed drainage" of the urinary tract. Stents are designed specifically for placement in the urinary system. A stent is placed using a special instrument, a cystoscope or ureteroscope, which is passed into the bladder through the urethra (urethra).0075

The stent can be in the body for a long time (up to 3 months or more) until delivery. Depending on the quality of the stent, it may need to be replaced after 2-3 months. The stent is also removed using a cysto- or ureteroscope. It is worth saying that the presence of a stent in the body can cause some side effects: more frequent than usual, the urge to urinate, the admixture of blood in the urine, a feeling of incomplete emptying of the bladder, pain in the kidney area during urination and beyond. nine0075

As a prevention of problems in the functioning of the urinary system and to help the kidneys during pregnancy, it is very useful to do the exercise "drainage position" - this is standing in a knee-elbow position for 5-10 minutes several times a day (preferably more than 5 times, but less than more often the better).

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