Why is cystitis more common in pregnant women?
Women's urethra is short and located near the vagina and anus, making it easy for bacteria to enter the bladder. During pregnancy, hormonal and mechanical factors are added to this. Progesterone reduces the tone of the bladder and ureters, and the enlarged uterus puts pressure on the bladder, causing it to not empty completely. Residual urine becomes a breeding ground for microbes. Additionally, the composition of urine changes: more glucose and protein appear in it, which also facilitates the growth of bacteria.
- Short urethra and proximity to natural sources of bacteria
- Decreased bladder tone due to hormones
- Incomplete emptying due to uterine pressure
- Changes in urine composition
- Hypothermia and the habit of tolerating the urge
- Previous cystitis before pregnancy
Symptoms and how they differ from the norm
Frequent urination during pregnancy is normal both in the first and especially in the third trimester, when the uterus puts pressure on the bladder. The difference between cystitis is that urination becomes painful: pain and burning appear, often at the end, the urge is false, and little urine is released. There may be a tug in the lower abdomen, the urine becomes cloudy and has a strong smell, sometimes blood is visible in it. The temperature in uncomplicated cystitis is usually normal: its appearance indicates the spread of infection higher up to the kidneys.
- Cutting and burning when urinating
- Frequent urge with small amounts of urine
- False urges and feeling of incomplete evacuation
- Heaviness and pain above the pubis
- Cloudy urine with an unpleasant odor
- Sometimes there is blood in the urine
Survey
The diagnosis is confirmed by a general urine test, which shows an increased number of leukocytes, bacteria, and sometimes red blood cells. They must undergo a urine culture test to determine sensitivity to antibiotics: for pregnant women, this is not a formality, but the basis for choosing a drug. Urine is collected in a sterile container after hygiene, in a medium portion. Ultrasound of the kidneys and bladder is prescribed for repeated episodes, low back pain or suspected stones. Additionally, the gynecologist takes a smear, because the burning sensation may be associated with inflammation of the vagina.
- General urine test
- Urine culture with antibiotic sensitivity
- Correct collection of midstream urine
- Ultrasound of the kidneys and bladder according to indications
- Vaginal smear to rule out vaginitis
- Control analysis after completion of treatment
Treatment
The basis of treatment is an antibiotic, approved during pregnancy, in a course prescribed by the doctor. Some medications that are habitual outside of pregnancy cannot be used, and some are permissible only in certain trimesters, so choosing a medicine on your own is unacceptable. Be sure to finish the course completely, even if the cramps go away the next day: an untreated infection quickly returns. As an aid, it is recommended to drink more fluid, if there is no swelling or other contraindications, and not to endure the urge. Separately treat asymptomatic bacteriuria detected in culture, even without complaints.
- Antibiotic safe for a specific stage of pregnancy
- Full course without early cancellation
- Drink plenty of fluids in the absence of contraindications
- Mandatory treatment of asymptomatic bacteriuria
- Control urine culture after 1–2 weeks
- Refusal of self-medication and warming up
Prevention of recurrent episodes
After suffering from cystitis, a urine test is taken more often than usual, because relapses during pregnancy are not uncommon. Simple habits significantly reduce the risk: do not tolerate the urge, empty the bladder completely and after intimacy, wash from front to back, wear cotton underwear and do not sit in the cold. For women with frequent relapses, the doctor may prescribe a prophylactic antibiotic in a low dose before giving birth. Cranberries and herbal infusions do not replace treatment and are used only with the approval of a doctor.
- Regular and complete emptying of the bladder
- Urination after intimacy
- Hygiene from front to back
- Sufficient drinking regime
- Avoiding hypothermia
- Preventive therapy as prescribed by a doctor
