What should I do if urinary system infections occur during pregnancy?

Urinary infection is a common complication during pregnancy. Its incidence in pregnant women is as high as 10%, of which the most common in acute pyelonephritis.If you do not discover and treat it in time, it may cause serious consequences to pregnant women and babies, such as premature birth and low weight.

First, what is urinary infection?

Urinary infection, also known as urinary tract infection, is a infectious inflammation caused by bacteria directly invading the urinary tract.According to the infection site, it is divided into upper urinary tract infection and lower urinary tract infection. The former includes pyelone nephritis, and the latter includes cystitis and urethritis; urinary tract infections often occur in women, especially in sexual life active period and postmenopausal women.

2. Why are urinary infections during pregnancy?

1. The increase in vaginal secretions after pregnancy can easily lead to vaginal peripheral bacterial infection;

2. The glomerular filtration rate increases, while the renal tube’s ability to absorb glucose has not increased accordingly, resulting in increased glucose content in the urine and easy to grow in bacteria;

3. During pregnancy, uterine enlargement compresses the ureter, leading to poor urination;

4. During pregnancy, female and progesterone secretion increases, and the tension of renal pelvis, kidney, and urinary tube muscles will be reduced, resulting in the expansion of pipelines and slow peristalsis;

5. Age, educational level, history of personal urinary tract infection, history of childbirth, history of abortion, anemia, and combined with gestational diabetes are all risk factors for pregnancy and urology infections.

3. What are the manifestations of urinary infections during pregnancy?

1. Asymptomatic bacterial urine: When the bacteria continuously breed and reproduce in the urinary system, those with no urinary infection are called asymptomatic bacterial urine.Symptoms of non -symptomatic bacteria during pregnancy will not disappear by themselves. 30%to 40%will develop into acute urinary infections. It can be screened through prenatal examination and urine culture.

2. Acute cystitis: manifested as bladder stimuli, that is, frequent urination, urgency, dysuria, discomfort in the lower abdomen, and occasional hematuria;

3. Acute pyelonephritis: The most common in urinary infection during pregnancy.Suddenly, the cold war and high heat appeared above 40 ° C, which could also be low.With headache, soreness, nausea, vomiting and other systemic symptoms, as well as back pain and bladder stimuli, lower abdomen pain during urination.The rib and waist point (the outer edge of the lumbar muscle and the second ribs of the second ribs) has tenderness, and the kidney area is positive.

What inspections should I do?

1. Physical examination: Usually record the temperature, pulse rate, respiratory frequency, blood pressure, and observe whether there are abnormalities; whether there are tenderness, soreness on the waist, groin and pubic bone;(Normal range of 100 to 160 times/min), you should refer to the obstetrician’s fetal heart monitoring.

2. Regular urine examination: check every half month to January. If abnormalities occur, you should seek medical treatment in time. Early discovery and early treatment.The urine specimen is generally good for the morning urine in the middle of cleaning;

3. Cultivation of urine microorganisms+medicinal sensitivity: Take the middle urine in the middle of cleaning, and use sensitive antibiotic treatment according to the results of the drug sensitivity;

4. Urinary ultrasound examination: Check the structure and morphology of kidney, ureter, bladder and other structures, whether there are kidney stones, renal stagnation, renal tuberculosis, ureteral stones, bladder stones, tumors and positional lesions.

5. How to treat urinary infections during pregnancy?

1. General treatment: pay attention to rest, drink plenty of water, and the daily urine volume is maintained above 2000ml to prohibit sexual life;

2. Antibiotic treatment:

① Asymptomatic bacterial urine and acute cystitis are preferred oral antibiotic therapy. The second or third generation of sensitive cephalosporins can be selected. It is best to give antibacterial drugs for 10 to 14 days according to the results of drug sensitivity tests.After 1 to 2 weeks after treatment, the reconciliation of urine is checked. If the result is still positive, replace antibiotics and continue to be treated until 6 weeks after giving birth;

② Once the acute pyelone nephritis is diagnosed, it should be hospitalized as soon as possible. The venue is treated with antibiotics for about 2 weeks. After discharge, antibiotics will be continued to prevent recurrence for 1 to 2 weeks., Negatives regularly review urine routine and urine culture.

③ The choice of antibiotics of pregnant women should consider the treatment effect, and at the same time, avoid using drugs that have adverse effects on the fetus. You can choose cephalosporin and penicillin antibiotics, while chimone, amino glycoside, chloramphenicol, tetracycline antibiotics try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try to try as much as possible.Avoid use.

3. Symptoms of support: such as replenishment, correction of hydrolytic electrolyte disorders and imbalances of acid and alkali, when the body temperature is too high, it can be cooled.

6. How to prevent urinary infections?

1. Scientific diet, drink plenty of water, eat more fresh fruits and vegetables, eat less spicy and irritating food, quit smoking and ban wine;

2. Wash it frequently, change the underwear frequently, and keep the perineal area clean;

3. It is best to avoid sexual life during pregnancy;

4. Don’t take urine and empty the bladder in time;

5. In the middle and late pregnancy, take the side position to avoid increasing uterine compression of the ureter;

6. Regularly go to the hospital for examination. If there are abnormalities, treatment should be treated as soon as possible.

(Author: Ren Ruilin, Zhang Wuxing. The 8th Medical Center of the General Hospital of the PLA)


[1] Zhu Fengcheng, Li Ruiman. Diagnosis and treatment of pregnancy with urinary system infection [J]. Chinese Magazine Chinese Magazine, 2017,04: 234-237.

[2] Zuo Wei, Zheng Hongguang. Urban infection during pregnancy [J]. China Practical Village Doctor Magazine, 2005,03: 9-10.

[3] Pietrucha-Dilanchian P, Hooton TM.Diagnosis, Treatment, and Prevention of Urining TractMicrobiol Spectr, 2016, 4 (6).

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