URINARY TRACT INFECTION IN PREGNANCY

A urinary tract infection (UTI) is an infection that begins in the urinary system. UTIs limited to the bladder can be painful and annoying.

Parts of the urinary tract two kidneys - a pair of purplish-brown organs located 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 located in the lower abdomen. two sphincter muscles - circular muscles that help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder. urethra -the tube that allows urine to pass outside the body.

Pregnancy and urinary tract infections: CHANGES IN THE URINARY SYSTEM DURING PREGNANCY Kidney enlargement Compression of the ureters and bladder Incomplete emptying of the bladder The urine is not as acidic It contains more sugars, protein, and hormones.

Types of UTI in pregnancy ASYMPTOMATIC BACTERIURIA silent (without symptoms) infection caused by bacteria present in the woman's system before pregnancy may lead to pyelonephritis if left untreated. ACUTE URETHRITIS OR CYSTITIS symptoms including pain or burning with urination, frequent urination, feeling of needing to urinate, and fever. PYELONEPHRITIS a kidney infection symptoms of acute cystitis plus flank (back) pain may lead to preterm labor, severe infection, and adult respiratory distress syndrome.

The most common causative organism of UTI Escherichia coli (E. coli) Other organisms may also cause UTI group B streptococcus, and sexually transmitted gonorrhea and chlamydia.

Signs and symptoms A strong, persistent urge to urinate A burning sensation when urinating Passing frequent, small amounts of urine Blood in the urine (hematuria) or cloudy, strong-smelling urine

Diagnosis: Dip slide technique Treatment: For 7 to 10 days Ampillicin 500 mg qid Nitrofurantoin 100 mg qid Cephalexin 500 mg tid Amoxicillin – Clavulanic acid 375 mg tid In case of recurrent infection, Nitrofurantoin 50mg or Amoxycillin 250mg at night to continue till delivery

Cystitis Results from bacterial infections of the bladder Often in the 16th week of pregnancy with marked retroversion of the gravid uterus Urine examination reveals:RBC,pus cells and bacteria Treatment:antimicrobial therapy and correction of retoversion.

Pyelonephrititis Condition characterized by an inflammation of the renal parenchyma and collecting tubules Predisposing factors: Progesterone Pressure by the gravid uterus

Clinical features Symptomatic manifestations like fever, malaise, nausea, vomiting and urgency of micturition and tenderness at renal angle of the affected side. Investigations Hb, TC and DC, C – reactive protein Blood culture Urine:smear,culture and antibiotic sensitivity Renal function test

Management Admission to hospital Complete bed rest Intravenous fliuds Intravenous antibiotics Antipyretics Continuation of treatment with oral antibiotics for at least 2 weeks

Complications Septicemia ARDS Renal abscess and scarring Preterm labour and delivery Increased perinatal morbidity and mortality DIC

Prevention of UTI Drink plenty of liquids Urinate promptly Wipe from front to back Empty your bladder as soon as possible after intercourse. Also, drink a full glass of water to help flush bacteria. Avoid potentially irritating feminine products