SingaporeMotherhood | Pregnancy

October 2013

Pregnant? Watch out for UTI Woes

A month ago, I experienced some bleeding while urinating. You can imagine my anxiety and fear as I was 15 weeks pregnant then. I thought I was going to have a miscarriage.

About 30 minutes after the bleeding started, I felt cramping pains in my lower abdomen. I rushed to the hospital as it was becoming increasingly painful to move. 

My doctor did not immediately suspect UTI (Urinary Tract Infection). I was not aware that I could have UTI without experiencing pain while peeing, and so did not flag it out to him when he asked if I was having difficulty peeing.
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UTI (also known as acute cystisis or bladder infection) can spring up anytime. However, it is actually very common among women, women are especially prone to it when they are pregnant. 

According to the KK Women and Children’s Hospital website, 20 per cent of women aged twenty to 65 years suffer at least one attack per year. Dr Paul Tseng, a gynaecologist in private practice, reckons that UTI occurs in some eight to 10 per cent of all pregnancies. That works out to nearly 10 out of 100 women.

This is due to the hormonal and physical body changes that come with pregnancy. Such changes include an increase in the level of estrogen, which makes the urinary tract more susceptible to UTI-causing bacteria. The growing uterus also pushes down on the bladder and compresses the ureters (the tubes between the kidneys and the bladder), making it harder for urine to drain as quickly. This allows bacteria to thrive and grow in the urinary tract.

At the hospital, the contractions subsided and I was sent home after having blood drawn for further tests. I was given medication to relax my womb and to treat a vaginal infection (which was identified as a possible culprit for the bleeding and irritated uterus). I was also told to rest. 

After a few days, the bleeding subsided, and I thought I was in the clear. However, the pain returned with a vengeance two weeks later. This time, the doctor found high levels of bacteria in my urine, a clear sign of UTI. I was prescribed a five-day course of antibiotics and over this period, the bleeding stopped.

Now, at 20 weeks pregnant, I still get lower abdominal pains and light bleeding especially when I am dehydrated or overly tired. A midwife friend recommended some pills which were made up of different herbs. She also advised me to drink Chinese parsley tea daily. This is done by steeping fresh chopped coriander leaves in hot water for 10 minutes. Parsley tea has been used traditionally to treat UTI and kidney stones due to its diuretic and anti-fungal properties.

The symptoms and intensity of UTI differ from person to person. Charlotte, 39, a freelance designer and mother of one, suffered sharp stinging pains when urinating. She also noticed blood and blood clots in the toilet bowl. She chose not to see a doctor, but recovered after drinking lots of water and home-made barley cooked with Chinese herbs.

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Lauren, 34, investor relations manager and mother of one, had UTI with bleeding during the first trimester of her pregnancy. Her gynae did a urine test which indicated a positive result for UTI. She was prescribed a single-dose antibiotic.

If you have been experiencing frequent UTI attacks normally, you may find the occurrences decreasing after giving birth. Since her 20s, Evelyn, 36, a writer and mother of two, had had monthly or bi-monthly episodes of UTI. She found her UTI attacks easing off after pregnancy. After becoming a mother, the occurrences fell to about twice a year.

Dr Chris Chong, a urogynaecologist in private practice, says that this could be due to a variety of reasons such as a change in diet, an increase in probiotics intake, a decrease in sexual activity, or a change in vaginal flora (of microorganisms) after delivery.

According to Dr Tseng, most of the UTI-causing bacteria originates from the bowel (usually Escherichia coli known as E. coli). This means that if you suffer from constipation, there is more bacteria present in the bowel, which may increase the likelihood of contracting UTI. Constipation also makes it harder to empty your bladder.

Here are some tips on how to prevent UTI when pregnant:

  • Hydrate, hydrate, hydrate! Drink plenty of fluids (plain water is the best), at least 1.5 to 2 litres a day.
  • Pee when you need to. Do not hold your urine.
  • Constipated? Treat it promptly. Blocked bowels can increase your chances of a bladder or kidney infection.
  • Clean your genital area and take a pee before and after intercourse.
  • Wipe from front to back after using the toilet.
  • Clean right. Your genital area only requires mild soap and water to get clean. Do not use strong soaps and douches.
  • Wear cotton underwear. This allows for good air circulation.
  • Avoid wearing tight-fitting pants.

And here are some tips specially for pregnant moms:

  • If you have problems drinking water, especially at the early stage of pregnancy when you have nausea symptoms or find the taste of water repelling, add some lemon juice into your water. This makes it more palatable. Take frequent sips instead of swallowing large amounts at one go.
  • If you are working full-time, take frequent mini-breaks. Even walking to the photocopier or picking up the newspaper to have a read is good. Regular movements could help to encourage the urge to pee.
  • If you suspect that you have UTI, see your gynae immediately. Early detection can prevent complications as bacteria can travel up your bladder to your kidneys, and kidney infections that are left untreated can lead to pre-term labour.

As the old adage goes, prevention is better than cure. And where UTI and pregnancy are concerned, it’s even more so. Don’t you agree?

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Pregnant? Watch out for UTI Woes