Urinary Tract Infections in Pregnancy

Women's Health, Pregnancy | October 7, 2017 | Author: Naturopath

pregnancy

Urinary Tract Infections in Pregnancy

Pregnant women are more susceptible to a wide-range of infections, with urinary tract infections (UTIs) being the most common type. In 80% of cases Escherichia coli is the most common infectious pathogen found in urine samples, followed by Staphylococcus saprophyticus. Higher bacterial counts in the urine are present in 2-10% of pregnancies and sometimes cause no symptoms. If symptoms of a UTI are present they include pain when urinating, increased urinary urgency, blood in the urine and pelvic pain. If infection is left untreated 30% of UTI’s can develop into a kidney infection and is associated with low birthweight and pre-term delivery.

What increases the risk

The risk of experiencing a urinary tract infection in pregnancy begins in week 6 and peaks during weeks 22 to 24. In pregnancy, the risk of developing a UTI is higher due to the following factors:

  • Low socio-economic status
  • Sickle cell trait
  • Diabetes mellitus
  • Neurogenic bladder retention (bladder malfunction which can result in the retention of urine)
  • History of previous urinary tract infections
  • Structural abnormalities of the urinary tract
  • Kidney stones

Why infection is more common in pregnancy

The growing foetus places pressure on the bladder and urinary tract. This can trap bacteria and prevent the bladder from fully emptying. Apart from this there are also physical changes to consider. From 6 weeks gestation, the urethra dilates and continues to do so until the delivery. The larger urinary tract, along with increased bladder volume and a decrease in bladder tone, allows bacteria to thrive. To complicate matters, a pregnant women’s urine is more concentrated. It can have higher amounts of sugar which encourage the growth of microbes and reduces the ability of the body to fight them off.

Types of urinary tract infections (UTIs) include:

  • Urethritis—infection of the urethra
  • Cystitis—infection of the bladder
  • Pyelonephritis—infection of the kidneys

Symptoms of UTI’s

Symptoms of UTI’sSome of the symptoms of UTI’s include pain above the pubic bone and a feeling of needing to urinate frequently, even if it’s only a very small quantity. Usually a burning and painful sensation is experienced when urinating and the bladder still feels full even after emptying. Sometimes the urine is cloudy, has blood present and smells unpleasant.

Kidney infection

If infection has reached the kidneys, seek medical advice urgently. In addition to the above symptoms chills, fever, lower abdominal pain and pain in the back may also be experienced.

Ways to prevent a UTI

There are many ways in which you can prevent an UTI during pregnancy by incorporating general dietary and lifestyle suggestions and supplementation if necessary.

Lifestyle changes

Avoid wearing clothes made from synthetic fibres which trap heat and promote sweating. Instead opt for natural fibres such as cotton which allows the skin to breathe. In the same sense avoid restrictive clothing.

After urinating, gently blot dry with toilet paper and keep your genital area clean. Make sure you wipe from front towards the back. Urinate before and after sex to clean the area and during infection avoid sexual contact. There is no need for douche’s, strong soaps, feminine hygiene sprays and antiseptics.

Develop the habit of urinating when the urge is felt (and yes this is already more frequent during pregnancy!). Make sure the bladder is fully emptied to avoid any retained urine that may lead to infection.

Diet for a healthy urinary system

Diet for a healthy urinary systemAvoid refined carbohydrates and all simple sugars. These dietary factors feed unhealthy bacteria and allow them to thrive.

Avoid alcohol, caffeinated beverages, spicy foods and any other foods which may cause urinary irritation. Stay hydrated by drinking 8 glasses of water daily. Keeping fluid intake to recommended levels reduces urine concentration and flushes the kidneys and urethra of bacteria.

Eat foods rich in nutrients and antioxidants to increase the immune response. This includes garlic, onions, berries, vegetables, fruit, wholegrains, fish and sufficient protein. 

Supplements to help with UTIs

All the supplements suggested are safe to take during pregnancy. They are particularly helpful in women who are susceptible to infection and want preventative products that are safe for everyday use. Some suggestions such as probiotics and cranberry have proven useful during acute infection.

Probiotics

Various kinds of probiotics are located throughout a pregnant women’s body, including the bladder and vagina. Studies have shown that women with recurrent UTIs have increased uropathogens in the vagina and it’s opening. The most documented strains, effective in reducing UTIs by reducing unwanted pathogens include Lactobaccillus rhamnosus and Lactobaccillus reuteri [fermentum].

Cranberry juice

Cranberries, especially its juice, has been used traditionally to treat and prevent UTIs. A number of trials have shown cranberries to be highly effective, non-toxic and safe enough to use during pregnancy and breastfeeding. They contain ᴅ-Mannose and procyanidins which prevent bacteria from adhering to the cells that line the wall of the bladder. Buying a superior quality tablet or unsweetened 100% pure juice is essential. A low dose can be taken as a preventative, while a very high dose short-term can help resolve an infection quickly.

Vitamin cVitamin C and bioflavonoids

Vitamin C is an essential nutrient for the immune system and can easily be lacking due to cooking and storage methods, even if fresh fruits and vegetables are consumed. Bioflavonoids are naturally found in foods containing vitamin C.

In the body, vitamin C and bioflavonoids act synergistically, that’s why they are best taken together in a supplement. Both these nutrients can be found in tablet and powder from and may protect the body from other infections, such as colds and flu’s.

Zinc

One of the major roles of zinc is to enhance the function of the immune system and to eliminate harmful pathogens from the body. It is estimated that over 80% of pregnant women have inadequate zinc intakes, making supplementation important in most cases. Zinc may prevent against other infections too, not just those affecting the urinary system.

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References

http://americanpregnancy.org/pregnancy-complications/urinary-tract-infections-during-pregnancy/

https://www.ncbi.nlm.nih.gov/pubmed/28216479

Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia

Beerepoot M, Geerlings S. Non-antibiotic prophylaxis for urinary tract infections. Pathogens. 2016 Apr 16;5(2)

https://www.ncbi.nlm.nih.gov/pubmed/27092529

Ledda A, et al. Highly standardized cranberry extract supplementation (Anthocran®) as prophylaxis in young healthy subjects with recurrent urinary tract infections. Eur Rev Med Pharmacol Sci. 2017 Jan;21(2):389-393

https://www.ncbi.nlm.nih.gov/pubmed/28165546

http://www.who.int/elena/bbc/zinc_pregnancy/en/

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