PREGNANCY DAYS For most pregnant women, carrying a baby to term is largely a mysterious process. This section helps new parents answer some of the most important questions about pregnancy and childbirth.

Urinary Tract Infection

• What are the symptoms in urinary tract infection?
• I have no symptoms but my urine test is showing pus cells
• What is acute urinary tract infection?
• What is acute pyelonephritis and how will I be managed for this?

What are the symptoms in urinary tract infection?

These are the most common infections encountered in pregnancy because the urinary stasis is increased.the urinary tract becomes dilated and lax promoting stasis and reflux

You may go to the doctor for burning while passing urine,increased frequeny (some burning and increased frequency is seen normally also), fever with or without chills, pain in abdomen and  increased vomiting.

These are the general symptoms but grossly, it may be divided into

1. ASYMPTOMATIC BACTERURIA
2. ACUTE CYSTITIS
3. PYELONEPHRITIS

ASYMPTOMATIC BACTERIURIA

This is a condition in which,you will be asymptomatic but the urine test done as a routine in antenatal clinic will show presence of more than 10.5 colony forming units of bacteria  /ml of urine.

WILL I HAVE TO GET THIS TREATED?

YES ,because there are good chances that this will progress to acute symptomatic urinary infection.also therer are increased chances of

• Low birth weight babies
• Preterm deliveries
• Preeclampsia
• Maternal anaemia

A 7-10 day course of antibiotics is enough to eradicate these organisms from the urine

ACUTE SYMPTOMATIC INFECTION (CYSTITIS)

HERE YOU WILL FACE THESYMPTOMS MENTIONED EARLIER AND also show pus and /or blood in urine which may be microscopic .

This is also treated immediately with a 7-10 days of antibiotic course to prevend it from ascending up to the kidneys.

ACUTE PYELONEPHRITIS

It is the most serious form of urinary infection and can cause

• Maternal sepsis
• Preterm labor
• Premature delivery

Ths condition is seen more in the second trimester  and may present on both the side or single side.

WHAT ARE THE SYMPTOMS?

Onset may be sudden with fever with chills and pain in the lumbar region ( may or maynot be both sided).

Also there might be anorexia,nausea and vomiting

IS IT SERIOUS?

YES, pyelonephritis in pregnancy is a potentially serious condition because of sepsis and endotoxin production.

It may cause respiratory insufficiency ,alveolar damage and pulmonary edema. In some of you, it may progress to pulmonary adult respiratory adult syndrome.

Renal dysfunction can occur in as many as 25 % of anteaprtum cases. Maternal anaemia ma also get exaggerated.

WHAT IS THE TREATMENT?

Early and aggressive treatment is indicated and hospitalization is indicated, generally with intravenous injections, symptoms resolve in 2-3 days but a continuation with oral antibiotics should be givenfor 10 -14 days. Because therer are chances of recurrencesprophylaxis for the remainder of pregnancy can also be taken.

If group B Streptococcal infection has been detacted anytime in the past, antibiotics should be given in the labor time also.