Pregnancy

Cystitis in pregnancy: what is important to know

Cystitis is a frequent ailment in pregnant women. Let’s see together what are the causes, remedies and strategies to prevent it.

Cystitis is inflammation of the bladder and urethra ( the tube that connects the bladder to the outside) usually caused by a bacterial infection .

In about 80% of cases, the responsible microorganism is Escherichia coli , a bacterium normally present in the intestine, which under certain conditions can increase in number and infect the urinary tract.

Why is it easier to suffer from cystitis in pregnancy?

Cystitis is a very common ailment in women and becomes even more frequent while pregnant, due to the hormonal and physical changes of this particular period.

First of all, the high levels of progesterone cause a relaxation of the muscles of the bladder and urethra, slowing down the flow of urine and thus reducing its “cleansing” action on the urinary tract. In addition, they promote constipation , which in turn can lead to an excessive increase in intestinal bacteria , including Escherichia coli .

Furthermore, again for hormonal reasons, the pH of the urinary tract changes and becomes less acidic , reducing the protection against infections. 

To all this is added the growth of the uterus , which especially in the last months of pregnancy compresses the bladder and the ureter, hindering its complete emptying. Consequently, it is easier to create a stagnation of urine , which favors the proliferation of bacteria.

Finally, to make the situation worse, dehydration can arrive , which makes the urine more concentrated and richer in bacteria , increasing the risk of infections, bad intimate hygiene or sexual intercourse .

Cystitis in pregnancy: what are the symptoms?

Cystitis can manifest itself with one or more of the following symptoms :

  • frequent urination , i.e. the need to urinate often
  • difficulty urinating (pee dripping out)
  • burning or pain when urinating, especially in the final part
  • feeling that the bladder is always full or not completely emptied

Less frequently, it can be accompanied by : 

  • fever
  • blood in the urine (which turns pink)
  • cloudy or foul-smelling urine
  • lower abdominal pain or abdominal cramps

What to do if you suspect you have cystitis in pregnancy?

In the presence of suspicious symptoms, the first thing to do is contact the gynecologist or midwife . A neglected infection , in fact, could cause complications and put the health of mothers and children at risk.

The trusted professional will perform a visit and evaluate whether to request a urinalysis  and a urine culture to confirm the infection. In the event of a positive outcome, the most suitable treatment will be evaluated , which often includes antibiotic and/or anti-inflammatory therapy with drugs (sometimes accompanied by special supplements) without risks for the fetus . 

Beware of do-it-yourself instead , which is always not recommended while pregnant, even in the case of over-the-counter medicines and herbal or phytotherapeutic products. Suffice it to say that bearberry , typically used as a natural remedy for cystitis, is absolutely contraindicated in pregnancy because it can be toxic to the fetus.

How to relieve the symptoms of cystitis in pregnancy?

Pending the indications of the gynecologist, it is important not to reduce the introduction of liquids (thus thinking of reducing the urge to urinate): this strategy, in fact, favors the stagnation of bacteria in the bladder and risks worsening the infection. On the contrary, it is recommended to drink abundantly to stimulate diuresis and “clean” the urethra, speeding up healing.

In addition, it is important to maintain thorough personal hygiene and to change panties often . On the other hand, vaginal douches should be avoided , always not recommended during pregnancy unless prescribed by the doctor.

How to prevent cystitis in pregnancy?

Although cystitis tends to be very common in pregnant women, there are some good habits that can help prevent this annoying disorder . Let’s see together which ones.

1. Don’t ignore the urge to urinate

The habit of holding in pee stresses the bladder, which consequently fails to empty completely when you finally go to the bathroom. The consequence is a stagnation of urine , which promotes inflammation and infection.

In addition, it is recommended that you always empty your bladder after sexual intercourse .

2. Drink plenty

Hydration is a very important factor in preventing cystitis: drinking at least 1.5-2 liters of water a day , in fact, promotes diuresis and counteracts urine stagnation in the bladder. In addition, an adequate introduction of liquids fights constipation , which in turn can favor the passage of intestinal bacteria into the urinary tract.

In addition to water, there are some drinks that are particularly suitable for preventing cystitis and for alleviating symptoms in the presence of infection, such as red fruit teas (preferably as a dry extract) or mallow tea , bancha tea (green tea almost free of theine) and unsweetened cranberry juice . Instead, avoid caffeine, alcohol and carbonated drinks , which have an irritating effect on the bladder.

3. Wear natural fabric underwear

Synthetic fibers hinder proper transpiration, favoring the appearance of infections. Better then to wear cotton briefs , preferably white. Pants should also be natural-fiber, comfortable, and not too snug .

4. Follow proper intimate hygiene

To avoid altering the bacterial flora, the advice is to wash your genitals no more than twice a day and to use a delicate intimate cleanser . Also pay attention to the movement to be performed, which must always be from the vagina towards the anus and not the other way around.

5. Adopt a balanced diet

Some foods, in particular, are particularly useful for preventing cystitis or promoting its recovery. Among these we mention:

  • the cranberry, which facilitates the detachment of bacteria from the walls of the bladder and their elimination in the urine;
  • foods rich in vitamin C , with antioxidant properties and able to acidify the urine, making it less hospitable to the bacteria responsible for cystitis;
  • vegetables, fruit and whole grains , which by helping to fight constipation help reduce the risk of urinary infections.

6. Practice regular physical activity

Exercise helps boost your immune system . However, beware of prolonged contact with damp or sweaty clothing. For this reason, it is important to dry thoroughly after a shower, change underwear after sport and avoid wearing wet swimsuits for too long after the sea or the pool

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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