A urinary infection in pregnancy can have no symptoms or spread to the bladder or kidney. Learn about symptoms, testing, treatment and urgent signs.
Urinary tract infections in pregnancy occur when bacteria multiply in the urinary tract; they may cause no symptoms, may appear as a bladder infection or may spread to the kidney. Because an untreated infection in pregnancy has been linked with spread to the kidney and with preterm birth, it is important that it is looked for with a urine test and treated by a doctor.
What is a urinary tract infection in pregnancy?
A urinary tract infection in pregnancy can be seen across a range, from bacteria present without symptoms to a bladder infection and, at a more advanced level, a kidney infection.
Can bacteria be found in your urine without complaints?
Finding bacteria in the urine without symptoms is called asymptomatic bacteriuria. The person feels no complaint; this condition is found only with a urine test.
Which symptoms can be seen in a bladder infection?
Symptoms of a bladder infection can include burning when passing urine, passing urine often or urgently, cloudy or bad-smelling urine, blood in the urine and lower abdominal pain.
Which symptoms can appear if the infection spreads to the kidney?
When the infection spreads to the kidney, symptoms such as fever or a very low body temperature, shivering or chills, pain in the back or side, nausea and vomiting, and feeling unwell can be added. An infection that spreads to the kidney in pregnancy is a condition that may need close monitoring in hospital.
Do urinary complaints alone show an infection?
Complaints at the bladder level (burning, frequent urine) can sometimes be mixed up with the usual discomforts of pregnancy; for this reason a symptom alone does not give a diagnosis, and a urine test is needed. Tell your health team without delay about complaints such as burning when passing urine or passing urine often.
How is a urinary tract infection detected?
Screening with a urine culture is recommended to detect asymptomatic bacteria in pregnant women; a urine culture may be requested in early pregnancy. The diagnosis is made with a urine sample; how the sample is taken (such as midstream) and the laboratory result are important, and the doctor following you interprets the result. The screening method and its timing can vary according to country and institution; the doctor following you determines the suitable method for you.
How is it treated?
Treating asymptomatic bacteria may reduce the likelihood of kidney infection, preterm birth and low birth weight; but the certainty of the evidence on this is low, and antibiotic treatment can have harms of its own. For this reason your doctor makes the treatment decision by weighing the benefits and the possible harms together.
Treatment consists of a course of antibiotic, chosen according to the urine culture result and usable in pregnancy; the doctor decides which medicine to use and for how long. Do not start, change or stop the medicine part-way on your own; if your doctor wishes, a follow-up urine test after treatment may also be requested.
If the infection comes back, your doctor can consider additional measures.
What can it mean for the mother and baby?
A urinary tract infection in pregnancy has been linked with preterm birth and low birth weight; in severe cases a serious illness can also develop for the mother. These findings are based on studies with low certainty of evidence and do not mean the same outcome will be seen in everyone; early diagnosis and treatment aim to reduce these likelihoods.
How can you support yourself?
- Have the urine tests requested at all your antenatal check-ups.
- Report complaints such as burning or passing urine often without delay.
- If you are taking an antibiotic, complete the course as your doctor has told you.
- Always report it if you have a medicine allergy.
- If your doctor wishes, have the follow-up test done without missing it.
What can you ask your doctor about the urine test and treatment?
- Ask when and why my urine test was requested.
- If treatment is needed, find out which medicine will be used and for how long.
- Ask whether a follow-up test is needed after treatment.
- Talk about what I should do if my symptoms increase or if I have fever, shivering or back pain.
- Ask what additional measures there could be if the infection comes back.
Frequently Asked Questions
I have no symptoms but bacteria were found in my urine; is treatment needed?
Generally yes. Your doctor does not look only at the culture result when making this decision; they also assess together your week of pregnancy, any history of earlier urinary tract infection and your general health. For this reason the same result can be handled differently in different people; having your regular urine tests even if you have no symptoms allows this assessment to be made in good time.
Does an antibiotic harm the baby?
There are groups of antibiotics regarded as safe to use in pregnancy, and your doctor chooses one of them according to the urine culture result. Using an antibiotic on your own or stopping a course part-way is not recommended; the real risk may come from an infection that is not treated and spreads to the kidney.
How does a kidney infection differ from a bladder infection, and why is it more important?
An infection that spreads to the kidney can turn into a more serious illness and may need closer monitoring in hospital in pregnancy. For this reason, when you notice fever, shivering or back or side pain, being assessed without delay allows treatment to be started early.
Does a urinary tract infection affect birth?
The exact timing and mode of birth are planned separately by the team following you by assessing your pregnancy as a whole, including the history of urinary tract infection. Not missing the follow-up visits and tests requested after the infection helps a possible recurrence to be noticed early.
Can bacteria be found in my urine without any complaint?
Yes. Asymptomatic bacteriuria causes no complaint and is found with a urine test. Screening with culture is recommended in pregnancy; your doctor decides the timing.
Do burning or frequent urine alone show an infection?
No. They can be mixed up with the usual complaints of pregnancy; a urine test is needed. Tell your health team about these symptoms without delay.
Is the way the urine sample is taken important?
Yes. How the sample is taken and the laboratory result are important in the assessment. Follow the sample-taking instructions given to you and talk about the result with your doctor.
Can I start any antibiotic myself?
No. The antibiotic that can be used in pregnancy is chosen according to the culture result. Do not start, change or stop the medicine part-way on your own.
May a follow-up urine test be needed after treatment?
Yes. Your doctor may request a follow-up test. You should not miss the check-ups and tests that are requested.
If the infection spreads to the kidney, may monitoring in hospital be needed?
Yes. A kidney infection in pregnancy can turn into a more serious picture. Being assessed without delay for fever, shivering or back and side pain is important.
Is the benefit of treatment certain for all outcomes?
No. Treating asymptomatic bacteria may reduce some likelihoods, but the certainty of the evidence is low and the antibiotic has possible harms too. The decision is made by weighing benefit and harm together.
If I have had a urinary tract infection, is a bad pregnancy outcome certain?
No. The link with preterm birth and low birth weight does not mean the same outcome will be experienced by everyone. Monitoring and treatment aim to reduce these likelihoods.
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