Symptoms of Acute Cystitis in Pregnancy: Key Risks and Precautions

Acute Cystitis and Pregnancy: Understanding the Risks and Precautions

Acute cystitis is a common but painful urinary tract infection diagnosed among many pregnant women. The risk of urinary tract infection, and, in particular, acute cystitis, is increased in pregnancies as the body and the immune system undergo various anatomic changes.

Acute cystitis in pregnant women may pose a significant challenge, considering the disease would not only cause discomfort but also carry implications for the health of the mother and the fetus. Continue reading to learn more about acute cystitis symptoms, causes, risks associated, and treatment options.

What is Acute Cystitis?

Acute cystitis is an infection of the bladder that occurs due to inflammation caused by the entrance of bacteria into the urinary tract. Though this urinary tract infection (UTI) can occur in both men and women at any age, it is more prevalent in women due to the relatively short length of the female urethra, which offers easy access to the bacteria for entering the bladder.

UTIs, including acute cystitis, are more likely during pregnancy because of physiological changes, such as hormonal shifts, an enlarged uterus, and changes in the urinary tract, which can reduce urine flow and facilitate the growth and multiplication of bacteria.

How Does Pregnancy Affect the Risk of Acute Cystitis?

Pregnancy leads to several physical changes that can make a woman more susceptible to acute cystitis. Some of these are:

Hormonal Changes

The hormonal changes during pregnancy, including an increase in progesterone, relax the muscles within the urinary tract, causing retention of urine. This situation creates an opportunity for the multiplication of bacteria and hence bladder infection.

Enlarged Uterus

As the pregnancy advances, the uterus expands and may exert pressure on the bladder, which in turn may cause difficulty in emptying the bladder. This stagnant urine provides fertile ground for bacteria.

Immune System Suppression

Pregnancy naturally suppresses the immune system to prevent the mother's body from rejecting the fetus. However, this reduced immunity makes it harder for the body to fight infections, including acute cystitis.

Increased Urinary Tract Sensitivity

Pregnancy increases blood flow to the pelvic region, which makes the urinary tract more sensitive and likely to be irritated by bacteria.

Acute Cystitis Symptoms: How to Identify Them?

It is important to recognize the symptoms of acute cystitis, especially in pregnancy, when an untreated infection may lead to complications. Some of the most common symptoms include:

Pain or Burning During Urination: One of the most regular acute cystitis symptoms includes a frequent and painful burning sensation in passing urine.
Frequent Urination: Acute cystitis is also marked by a feeling of urgency to urinate, usually with minimal urine output.
Lower Abdominal Pain or Pressure: In the lower abdomen, a dull ache or a sharp pain may be felt, and sometimes it worsens during or after urination.
Cloudy, Dark, or Bloody Urine: The urine might be cloudy or odorous. Blood in the urine may occur due to acute cystitis with hematuria, which is a frequent sign of an irritative or infectious process within the bladder.
Fever and Fatigue: A mild fever or general feeling of malaise often accompanies acute cystitis, especially when the infection is severe.

During pregnancy, it may be difficult to differentiate the symptoms of acute cystitis from regular discomfort, such as frequent urination. However, it is important to note any discomfort that seems out of place and continues.

Acute Cystitis with Hematuria vs. without Hematuria

A major symptom of acute cystitis that is important to observe is hematuria, or the presence of blood in the urine. Although not all patients who suffer from acute cystitis develop hematuria, when present, this sign may signify a more severe infection or irritation to the bladder wall.

The table below outlines the key differences between Acute Cystitis with Hematuria and Acute Cystitis without Hematuria:

Aspect	Acute Cystitis with Hematuria	Acute Cystitis Without Hematuria
Definition	Characterized by visible blood in the urine, giving it a pink, red, or brown appearance.	Occurs without visible blood in the urine, but symptoms of pain, burning, and frequent urination are present.
Causes	Inflammation or infection that irritates the bladder's blood vessels.	Primarily caused by bacterial infections, risk factors include sexual activity and hygiene.
Symptoms	Visible hematuria (blood in urine), painful urination, frequent urination	Strong, persistent urge to urinate, burning sensation during urination, passing small amounts of urine frequently
Severity	Strong, persistent urge to urinate, burning sensation during urination, passing small amounts of urine frequently.	Less alarming than hematuria, it still requires medical treatment to prevent complications.
Diagnosis	Based on the presence of hematuria and typical UTI symptoms, urinalysis confirms infection.	Diagnosed through symptom presentation and laboratory tests like urinalysis and urine culture.
Treatment	Typically involves antibiotics to treat the underlying infection; hydration is important.	Treatment includes antibiotics and hydration; avoiding bladder irritants is also recommended.
Complications if Untreated	It can lead to more severe infections such as pyelonephritis (kidney infection).	Untreated cases may result in recurrent infections or chronic bladder dysfunction.

Acute Cystitis in Pregnancy: Risks and Concerns

When pregnant women are affected by acute cystitis, there are added issues that have to be considered. The infection could then spread from the bladder into the kidneys and may develop into pyelonephritis, leading to worse complications such as:

Preterm Labour: Untreated urinary tract infections, such as acute cystitis, have been associated with an increased risk of preterm birth. The infection can stimulate inflammatory responses that cause uterine contractions and premature labour.
Low Birth Weight: Infections like acute cystitis during pregnancy increase the chances of delivering a low-birth-weight baby that could be complicated at the time of delivery.
Kidney Damage: If the infection moves to the kidneys, it can cause damage to the kidneys or even lead to kidney failure, which poses significant risks to the mother and the baby.
Increased Risk of Recurrence: Pregnant women who have developed acute cystitis may be more likely to suffer from recurrence of UTIs during their pregnancy and even after delivery.

Acute Cystitis Treatment in Pregnancy

Prompt treatment is of utmost importance to prevent acute cystitis complications during pregnancy. Treatment usually involves:

Antibiotics

Safe antibiotics are prescribed to treat acute cystitis in pregnancy ICD 10. These antibiotics inhibit bacteria that cause infection. However, your healthcare provider will only consider some antibiotics that are safe for pregnant women to take and adjust the appropriate amount.

Hydration

Fluid intake can help flush out the bacteria that have infected the urinary tract, reduce the severity of symptoms, and promote recovery. Water is the best option as it supports the natural healing process and helps maintain overall bladder health.

Pain Relief

Over-the-counter analgesics, including acetaminophen, have the potential to provide relief from the discomfort commonly associated with acute cystitis. However, they should only be taken when and as prescribed by your healthcare provider.

Preventative Measures

Doctors may prescribe a daily dose of a preventive antibiotic or other medications during pregnancy to prevent recurring infections. In some cases, lifestyle changes, such as practising good hygiene, may also be advised to help prevent acute cystitis.

When to See a Doctor: Warning Signs and Complications

Most acute cystitis cases can be treated. However, in some cases, you need to seek medical attention right away:

High Fever: A fever of 101°F (38.3°C) or higher could indicate that the infection has spread to the kidneys.
Severe Abdominal or Back Pain: Intense pain in the lower abdomen or back can signify the involvement of the kidneys, which may need immediate medical attention.
Persistent Symptoms: Seek medical attention if symptoms are not relieved with antibiotics within a few days or become worse.
Blood in the Urine: If hematuria is present, or worsens, you should consult with your healthcare provider.

Preventing Acute Cystitis During Pregnancy

While it’s not always possible to prevent acute cystitis, there are several steps you can take to reduce the risk:

Stay Well-hydrated: Drinking water facilitates removing bacteria from your urinary system.
Hygiene Check: Be sure to wipe from front to back after using the bathroom. This will keep bacteria from entering the urinary system.
Do Not Hold Urine: Urinating is essential in preventing the presence of bacteria in the bladder.
Urinate After Intercourse: This would help flush out bacteria if they entered the urinary tract during sexual intercourse.
Wear Loose-fitting Clothes: Tight clothing, especially around the pelvic area, creates a moist environment for bacteria to grow. So, wear loose-fitting, breathable clothes.

Acute cystitis is one of the most common conditions that appear during pregnancy but requires extra attention to prevent complications. Being aware of acute cystitis symptoms, the danger they pose to the mother and the baby, and receiving medical care helps to effectively manage acute cystitis risk in pregnant women.

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FAQ's

What is acute cystitis in pregnancy?

Acute cystitis refers to an infection in the urinary tract that inflames the bladder. Since physiological changes characterise it, pregnancy might precipitate it more often.

Can acute cystitis affect my pregnancy?

Yes, untreated acute cystitis can lead to more severe infections and preterm labour.

What are acute cystitis without hematuria symptoms?

Common signs can include a frequent and urgent need for urination, a painful or burning sensation during urination, and passing only small amounts of urine each time.

Is acute cystitis with hematuria more serious than without hematuria?

Acute cystitis with hematuria is considered to reflect a more serious infection or irritation to the bladder lining. However, treatment to prevent complications is necessary for both forms of cystitis.