Cystitis is a rather frequent disorder in the female population, and even more so in the expectant population. In fact, to an innate physiological predisposition - given by an urethra close to the vaginal meatus, close to the anus and shorter than the male one - during pregnancy several predisposing factors are added.
Causes
Cystitis, or inflammation of the bladder wall, is favored by hormonal changes in pregnancy, since the rise of progesterone induces the relaxation of smooth muscles, also decreasing the tone of the ureter and urethra with consequent slowing of urinary flow (minor washing action of urine). In pregnancy, a further predisposing factor is represented by the mechanical compression exerted by the uterus growing on the ureter; especially in the last months of gestation, this phenomenon hinders the complete emptying of the bladder. Add to this the richness in the urine of nutrient substrates for germs, sometimes including glucose if gestational diabetes is present.
All these factors, in addition to the anatomical elements mentioned in the introductory part, facilitate the engraftment of vaginal or intestinal germs (escherichia coli) that ascend into the urethra; such colonization can be favored by sexual intercourse, especially if unprotected, and by poor personal hygiene.
Symptoms
The symptoms of cystitis in pregnancy are essentially attributable to the difficulty in the emission of urine, which is eliminated drop by drop, to pain and burning during urination, to the need to urinate often with a feeling of incomplete bladder emptying, and sometimes a loss of blood in the urine. Even in pregnant women there may be asymptomatic bacteriuria, ie a urinary infection with no symptoms.
Risks and Complications
Cystitis and bacteriuria, whether symptomatic or symptom-free, must always be treated, since a slight rise in the incidence of pyelonephritis (kidney infections) has been demonstrated, in turn associated with a modest increase in premature births and a reduction in the weight and general development of the unborn child. Although the risk is low, it is essential to adequately treat any cystitis that may develop during pregnancy.
Cure, diagnosis and prevention
In most cases, cystitis in pregnancy also respond well to short courses of antibiotic therapy, without significant side effects for both the mother and especially the fetus.
To avoid the risk of complications, also consider the frequent relapses, after the treatment it is recommended to perform a urine culture at least once a month until the end of the pregnancy. The same exam is generally performed for screening purposes around the 16th week of gestation. If the urine culture is negative, it is not necessary to repeat the test, unless there is a history of previous urinary tract infections or that the typical symptoms of cystitis arise.
To learn more: Drugs for the Treatment of Cystitis in Pregnancy »
SOME ADVICES
At the first symptoms that can lead to cystitis during pregnancy, contact your doctor to perform a urine test and urine culture. Do not spontaneously start any therapy (not even that used to resolve non-gravid cystitis). While waiting for the results, the doctor will recommend a non-specific antibiotic which will then be confirmed or replaced based on the result of the antibiogram. Your doctor may also prescribe paracetamol in the presence of pain, discomfort or fever. Cystitis symptoms normally vanish within a few days of starting therapy; however it is very important to complete the recommended therapeutic cycle even when the inflammation seems to have been overcome. If symptoms persist or worsen consult the gynecologist immediately.
As for the prevention of cystitis in pregnancy it is recommended to drink at least a liter and a half of water a day to promote diuresis, use underwear in natural fibers avoiding synthetic ones, obtain a regular urination without retaining urine for a long time, empty the bladder after every sexual intercourse, avoid aggressive intimate cleansers and regularize the alvus (the fecal stasis can favor the passage of the intestinal bacteria in the renal excretory ways with appearance of cystitis).
