Urinary Tract Infections (UTI's) & Cystitis in Pregnancy

September 02

  • Pregnancy

Urinary Tract Infections (UTI's) & Cystitis in Pregnancy

Learn more about how to recognise a UTI, how to prevent one and what you can do about it.

5 min read By Malena Monteverde, Registered Midwife

What’s a UTI?

A UTI is the general term used to refer to any infection that happens in the urinary system, which includes your urethra (the tube that carries urine out of your body from your bladder), bladder, two ureters (the tubes going from the kidneys to the bladder) and two kidneys. 

Most UTIs are caused by bacteria and, depending on where the infection is, may be described as lower UTIs – when it affects the urethra or bladder – or upper UTIs – where the kidneys or ureters are involved. Lower UTIs are much more common than upper ones.

Is Cystitis the same as a UTI?

Yes and no. 

Cystitis is an inflammation of the bladder that is generally caused by bacterial infection. Although it is the most common type of UTI, not all cystitis cases are caused by infection. Complications from illnesses such as diabetes, reactions to certain medications, long term catheter use or sensitivity to chemicals in some hygiene products can give rise to cystitis, too. In these latter cases, urine test results will come back negative, as no bacteria will be found in the urine.

Symptoms of cystitis include:

  • Frequency
  • Urgency
  • Pain, stinging or burning when passing urine
  • Blood in the urine
  • Urine that is cloudy, dark and/or has a strong or foul smell
  • Discomfort or pain in your lower tummy

Interstitial cystitis, or painful bladder syndrome, is a chronic inflammation of the bladder where symptoms that are similar to a UTI last 6 weeks or more and where infection or other recognisable causes are absent. Although pain during sexual intercourse is not a symptom usually associated with a UTI, it may be experienced by women with interstitial cystitis.


Are there other types of UTI?

Yes, and these are classified depending on where the infection is found.

When the infection affects the urethra, it is called urethritis. Symptoms may include a burning sensation when you pass urine and, possibly, discharge from the urethra.

Pyelonephritis describes an infection that has reached the kidneys. This is more serious and, if left untreated, could lead to preterm labour, cause miscarriage or result in permanent kidney damage. It needs urgent medical attention and treatment.

Symptoms of pyelonephritis may include a high fever, pain in lower and/or upper back, tightenings, chills, nausea and vomiting, as well as other UTI symptoms mentioned above.

Asymptomatic Bacteriuria is the presence of bacteria in your urine (which should be sterile) in the absence of symptoms. This is a condition for which is screened for at least once in your pregnancy (usually at your booking appointment) as 20-35% of women with asymptomatic bacteriuria develop a UTI if not treated. Treatment of asymptomatic bacteriuria can reduce the chances of a UTI by 70-80%.


Why do UTIs happen?

Most cases of lower UTIs, including cystitis, are caused by the Escherichia Coli (E. Coli) bacteria. This and other bacteria, that usually live in the bowel or on the skin and are harmless in those environments, can enter the bladder through the urethra causing infection.

In pregnancy, small but significant changes that happen to your urinary system can increase your chances of developing a UTI.


Can I prevent them?

You can reduce the risk of developing a UTI by:

  • Always wiping from front to back, even if you’ve only had a wee
  • Hydrating yourself well, as this will help flush out any bacteria that may be traveling up into your bladder
  • Not waiting to empty your bladder when you feel the urge
  • Emptying your bladder after having sex, regardless of whether this includes penetration
  • Making sure you empty your bladder fully every time you visit the loo
  • Avoiding perfumed products in your bath, shower or after 
  • Favouring underwear made of natural materials so the skin around your vulva can breathe


How are UTIs diagnosed?

UTIs are usually first diagnosed by your midwife or GP, who will consider your symptoms and concerns and ‘dipstick’ a sample of your urine to see if it shows any possible signs of infection.

They will then send the sample of urine off to the lab where it will be cultured and accurately tested for bacteria. These results will take a couple of days to be ready and will specify which type of antibiotic is suitable to treat the bacteria causing the infection.

You may receive a prescription for antibiotics before the test results are back if your midwife/GP thinks that your symptoms and/or evidence from the urine dipstick indicate an infection.


How are they treated?

Whether you have asymptomatic bacteriuria or a suspected or proven UTI, a 7-day course of antibiotics should be started promptly. If you are given antibiotics before the lab results are back, these may be changed to a different one if the results then show that another antibiotic may be more suitable.

Along with your antibiotics, some of the preventative measures listed above may help the treatment along, as well as alleviate some of the discomfort. You may also take some simple pain-relief, like paracetamol, if you need to.

Most UTIs in pregnancy are easy to treat and respond well to antibiotics.


When should I contact my midwife or doctor?

Any UTI could rapidly travel up to your kidneys, posing a potential risk to your pregnancy. Therefore, it is important to get medical advice and treatment as soon as possible if you are concerned.

Never hesitate to contact your midwife or GP if you suspect you may have a UTI. If your symptoms are severe before you are able to attend an appointment, you can contact the 24-hour maternity assessment unit at your local hospital.

If you have symptoms of a UTI which don’t show improvement within 2 days, or if they worsen, call your GP/maternity unit to get checked.



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