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Pregnancy hormones like progesterone relax the smooth muscles while the growing uterus compresses the bladder and ureters, which causes urine to pool and bacteria to grow. The kidney swells and filters more blood during pregnancy, which increases urine production. The suppressed immune responses during pregnancy fail to fight against infections, leading to UTIs and bladder infections in pregnancy.
How Pregnancy Changes Impact the Urinary Tract
Pregnancy brings a series of changes to the body to nurture the growing baby. When a woman gets pregnant, her body prioritises nurturing and protecting the fetus. So many other organs affect the body adapting to the natural changes of pregnancy, and the urinary tract is one of the most important systems which gets affected by the pregnancy changes.
Hormonal Effects
During pregnancy, progesterone increases and relaxes the smooth muscles throughout the body, including the urinary tract. This slows down the urine flow from the kidneys to the bladder. Ureterose and dilate up to 2 times in the second trimester. The slow urine flow becomes a pool and lets bacteria thrive, increasing infection risk.
Mechanical Pressure
As the uterus expands to accommodate the growing baby, it compresses the urinary system. The compression increases during the second and third trimesters. By 12 weeks, the bladder loses its capacity, leading to frequent urination. The growing uterus presses the ureters against the pelvic wall and obstructs urine flow from the kidney, swelling the kidney with urine.
Urinary Stasis and Vesicoureteral Reflux
The pool of urine creates urinary stasis and is the main reason for urinary problems in Pregnancy. When urine flow is delayed or pooled in the bladder, bacteria thrive, increasing infection risk. Sometimes urine flows backwards from the bladder to the kidneys, increasing kidney infection.
Immune Modulation
Pregnancy naturally reduces immunity to tolerate the fetus, which carries half-foreign genetics. This reduces the body's ability to fight infection, letting bacteria build up easily. Infections can progress fast.
Common Urinary Tract Disorders During Pregnancy
Urinary Tract Infection is the most prevalent urinary issue in pregnancy. When urine pools in the bladder and let bacteries thrive, ur cause a serious issue. The UTIs are divided into three types depending on their severity and location:
- Asymptomatic Bacteriuria: When bacteria are present in the urine without any symptoms, it's called asymptomatic bacteriuria. Untreated conditions can progress into severe Kidney infections.
- Acute Cystitis: Cystitis occurs when symptoms become noticeable. It means bacteria started to irritate the bladder lining.
- Acute Pyelonephritis: It's a serious kidney infection caused by pressure in the ureter.
Causes:
When the progesterone relaxes the ureter and the uterus compresses the bladder, it causes urine to pool. Diabetes, anaemia, and sickle cell diseases are also some common reasons.
Symptoms:
- Frequent urination and urgency
- Burning or pain while peeing
- Blood-tinged urine
- Foul smell in urine
- Lower belly pain while urinating
Prevention
- Drink enough water daily to flush toxins
- Empty the bladder regularly
- Wipe from front to back while cleaning
- Wear light, cotton underwear
- Don't hold urine for long hours
- Urinate after intercourse
Kidney Stones During Pregnancy
Kidney stones are not prevalent, but when they occur it can cause serious issues to pregnant women. It affects roughly 1 in 200 to 1 in 1500 pregnancies. Kidney stones form when minerals crystallise in the urine.
Symptoms
- Severe wave-like flank pain radiating to the lower abdomen, which is often worse when lying down
- Pink or red colored urine due to stone scratches
- Dehydration and severe vomiting
- Frequent urination or urgency
How it Affects Pregnancy
- Untreated kidney stones can lead to uterine contraction from pain, resulting in preterm delivery.
- Inflammation weakens the amniotic sac and causes premature Rupture of membranes.
- Stasis can lead to a urinary tract infection.
Hydronephrosis During Pregnancy
When urine accumulates, it can swell the kidney and cause hydronephrosis. It's just a normal side effect of pregnancy. When progesterone relaxes the uterine walls, it slows the urine flow, which ensures the kidneys.
Symptoms include dull lower back pain, frequent urination, and abdominal pain. In some cases, nausea and fever can arise.
Bladder Dysfunction and Urinary Incontinence
Bladder dysfunction and urinary incontinence are also the most prevalent urinary tract disorders in pregnant women. These can grow from the pregnancy changes.
A growing uterus compresses the bladder, which increases pressure during coughing and laughing. Relaxing and progesterone loosen the pelvic ligament and weaken support. Multiparty, obesity, constipation, smoking, UTI history, and previous incontinence can also increase the risk.
Incontinence can come in three types:
- Stress Incontinence: When you cough, sneeze, laugh, exercise, or lift heavy objects, the weak pelvic muscles cause leakage.
- Urge Incontinence: Sudden or intense urge to urinate with involuntary leakage caused by bladder muscle spasms.
- Mixed Incontinence: Symptoms of both urge and stress incontinence, which can be tough to manage.
Other Symptoms
In some cases, urinary symptoms can indicate other infections.
- Interstitial Cystitis: Bladder pain syndrome is a chronic inflammation caused by bladder wall problems. It can mimic UTI. It comes with severe pelvic pain, urgency to urinate, and pain worsens when the bladder fills.
- Vaginal Infections: Sometimes vaginal or perineal infections can cause itching, discharge or pain at the urethral opening. It can be more common in pregnancy as hormones change the pH levels in the vagina. Vaginal discharge with itching and pain in the perineum may indicate infections.
Bladder infections are common during pregnancy, which can result in various urinary tract issues. The most common is a urinary tract infection caused by a urine pool, which lets bacteria grow and thrive. The best way to prevent this is by drinking optimal water. Drinking enough water flushes toxins out. Follow hygiene practices and avoid wearing tight underwear. Do urine tests early if you notice an increase in frequency and burning in the area.
FAQs on UTIs in Pregnancy: How Pregnancy Affects The Urinary System
- How long does it take to flush out a UTI with water?
If you have a urinary tract infection, water alone won't work. You need antibiotics recommended by doctors. But with water, you can reduce the symptoms. Drink 2-4 litres of water to dilute urine and flush out bacteria, and urinate frequently to clear the urinary tract. Avoid caffeine, alcohol, and sugary drinks as they can irritate the bladder. - What foods should I avoid with a UTI?
If you have UTI, avoid acidic foods, including orange, lemon, tomato, grapefruit, and pineapple. Limit spicy foods as capsaicin can irritate the bladder. Reduce processed and salty foods. Sugary snacks and desserts can feed bacteria. - Can stress cause UTI?
Stress is not the direct cause of UTI. But stress hormones can lead to other problems, which can directly cause UTI. Stress hormones, such as cortisol, can reduce your body's ability to fight infections. Stress can trigger a fight or flight response, which can exacerbate UTI symptoms.