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What are urinary tract infections? — Urinary tract infections, also called "UTIs," are infections in the urinary tract. The urinary tract is the group of organs in the body that handle urine. It includes the kidneys, bladder, ureters, and urethra (figure 1).
UTIs can affect either the bladder or the kidneys:
●Bladder infections are more common than kidney infections. They happen when bacteria get into the urethra and travel up into the bladder. The medical term for bladder infection is "cystitis."
●Kidney infections happen when the bacteria travel even higher, up into the kidneys. The medical term for kidney infection is "pyelonephritis."
UTIs are common during pregnancy. When a pregnant person gets a bladder infection, it is more likely to lead to a kidney infection. This might be because the ureters (the tubes between the bladder and kidneys) get wider during pregnancy. This makes it easier for bacteria to travel farther.
What is asymptomatic bacteriuria? — This is the medical term for when there are more bacteria than normal in a person's urine, but the person does not have symptoms of infection. In pregnant people, doctors check or "screen" for this as part of routine testing. This involves a simple urine test and is usually done near the end of the first trimester.
What are the symptoms of a UTI? — Symptoms depend on which part of the urinary tract is affected.
If you have a bladder infection, symptoms can include:
●Pain or a burning feeling when you urinate
●The need to urinate often
●The need to urinate suddenly or in a hurry
●Blood in the urine
If you have a kidney infection, you might have the above symptoms, too. But kidney infections can also cause:
●Nausea or vomiting
Kidney infections during pregnancy can sometimes lead to more serious problems. These can include sepsis (when an infection travels through the whole body) and breathing problems. If you are pregnant and have symptoms of a bladder or kidney infection, tell your doctor or nurse.
How are UTIs during pregnancy treated? — UTIs are treated with antibiotics whether or not you are pregnant. Antibiotics work by killing the bacteria that cause the infection.
●If you have a bladder infection, you will probably need to take antibiotic pills. Most are taken for 3 to 7 days, but the exact schedule depends on which antibiotic you get. Your doctor will prescribe one that is safe to take during pregnancy. It's important to take all your antibiotic pills, even if your symptoms start to improve. After you are done taking the antibiotics, your doctor might test your urine to make sure the bacteria are gone.
●If you have a kidney infection, you will probably need treatment in the hospital. This involves getting antibiotics through a thin tube that goes into a vein, called an "IV." After your symptoms have improved, you will be able to go home from the hospital and switch to antibiotic pills. Your doctor might have you continue to take antibiotics for the rest of your pregnancy. This is to prevent the infection from coming back.
How is asymptomatic bacteriuria during pregnancy treated? — If you are pregnant and your screening test shows bacteria in your urine, your doctor will probably give you antibiotics.
In most cases, people with asymptomatic bacteriuria who are not pregnant do not need treatment. But doctors do recommend antibiotics for pregnant people. That's because without treatment, asymptomatic bacteriuria can raise the risk of problems with your pregnancy. Treating it with antibiotics also lowers the chances that it will lead to a UTI.
The antibiotic options for asymptomatic bacteriuria are the same as those used to treat bladder infections.
Will my baby be healthy? — If you get treatment, chances are very good that your baby will be healthy.
There is a small risk of certain problems if you have bacteria in your urine during pregnancy. These include preterm labor, which is when labor starts before 37 weeks of pregnancy, or having a baby that weighs less than they should. Babies who are born preterm or underweight can have health problems.
Kidney infection during pregnancy also increases these risks. This is why it's important to get treatment if you have asymptomatic bacteriuria or a UTI during pregnancy.
Can UTIs in pregnancy be prevented? — Sometimes. If you often get UTIs, especially if they tend to happen after sex, your doctor might prescribe you antibiotics during pregnancy. Taking 1 dose of your antibiotic after sex might help prevent getting a UTI. Your doctor or nurse can talk to you about whether this is something you should do.
Drinking plenty of fluids can also help prevent UTIs. This is true whether or not you are pregnant.