Cystitis during pregnancy
Cystitis, which is an inflammation of the mucous membranes of the bladder, is one of the most common diseases of the urinary tract along with pyelonephritis (inflammatory kidney disease). The most common cause of its occurrence is infections. During pregnancy, the disease may worsen.
Cystitis in pregnant women: causes
Frequent problems with the bladder in pregnant women are explained by several reasons at once:
anatomical structure – in women, the urethra is shorter than in men, besides, it is located next to the rectum / vagina, inhabited by various microorganisms, including pathogenic;
hormonal restructuring;
decrease in the effectiveness of the immune system;
violation of the vaginal microflora;
increase in the size of the bladder;
pressure on the ureters by the growing uterus.
Types of cystitis:
non–infectious – occurs rarely, usually with prolonged use of certain medications, the chemical composition of which irritates the mucous membranes of the bladder;
infectious – occurs as a result of infection, can be bacterial, mycoplasmic, fungal, viral, etc., is the most common.
In women, as a rule, with urinary tract infections, microorganisms enter the urethral canal and then enter the bladder from the perianal area located next to the anus and from the vagina.
The pathogens most often are:
80% – E. coli;
10-12% – staphylococcus;
rarely – Enterobacter Enterobacter, Klebsiella, Enterococcus;
sometimes – chlamydia, mycoplasmas, ureaplases, and other sexual infections.
Cystitis during pregnancy: symptoms
Symptomatically, the disease is divided into acute and chronic. The acute form begins rapidly, usually lasts about a week, less often – 10-15 days.
Acute cystitis of pregnant women is manifested by the following signs:
pollakiuria – frequent emptying of the bladder with pain, burning;
sometimes the inability to control the process, urination with a low percentage of urine excreted;
dysuria – painfulness of urination with severe pain;
pain in the lower abdomen, which increases with palpation, as well as when filling the bladder;
elevated body temperature (but not always);
urine may become cloudy, have blood inclusions.
If a woman has already been diagnosed with “chronic cystitis” before pregnancy, an exacerbation can easily begin during gestation. The symptoms are similar to acute inflammation, but not so pronounced. In addition, they are often confused with other diagnoses: for example, soreness during urination also occurs with urethritis, vulvovaginitis. In this regard, at the first unpleasant sensations, you should immediately contact a doctor and find out the diagnosis.
Diagnostics
The diagnosis of the disease is established by analyzing the (total) urine of a pregnant woman – this is the easiest way to determine the infection that has penetrated inside. A general laboratory analysis of urine reveals cystitis by a characteristic increase in leukocytes (leukocyturia), bacteriuria, moderate protein content, excess of the norm of epithelial cells. An increased white blood cell count is a 100% sign of the inflammatory process.
Expectant mothers take urine for general analysis from the first to the last trimester of pregnancy strictly on schedule. When the patient addresses complaints that are typical for inflammation of the bladder, the following types of examinations may additionally be prescribed:
urine examination by Nechiporenko, Zimnitsky;
bacteriological urine culture;
analysis of the vaginal microflora;
clinical blood test;
Ultrasound of the kidneys and/or bladder.
Ultrasound is prescribed for recurrent cystitis to identify the pathology accompanying it. Cystoscopy of the bladder is usually not performed – in order to prevent an exacerbation of cystitis. If the attending physician deems it necessary, the pregnant woman may be referred for consultation to a urologist.
Cystitis: early pregnancy
In the early stages of fetal gestation, cystitis can be triggered by a number of reasons. Suppression of immunity (immunosuppression) and hormonal restructuring of the body are the most important. In pregnant women, against this background, active reproduction of microorganisms, bacteria and Escherichia coli begins in the perianal region and in the vagina, and therefore infectious cystitis is very often observed.
In the first months of pregnancy, acute cystitis can easily be triggered by many factors, for example, allergies to hygiene sprays, spermicides, foams and bath salts, food products such as cabbage, nuts, legumes, etc. Exacerbation of the chronic form of the disease most often causes hypothermia and / or excessive fatigue of the body against the background of weakening of the immune system. Chronic cystitis can also be a relapse, manifested in the initial stages of pregnancy – it is at this moment that the woman’s body cannot resist infections due to suppressed immunity.
Important! Self-medication is fraught with dangerous complications. A number of drugs, which include, for example, sulfonamides and tetracyclines, are completely contraindicated in pregnant women. Treatment of cystitis is prescribed only by a doctor who, from the very beginning, monitors how the fetus develops and how the situation is with the health of the expectant mother. Many unpleasant and even dangerous situations such as kidney infection can be avoided by contacting the polyclinic in a timely manner.
In the early stages of pregnancy, it is necessary to prescribe treatment with extreme caution, since the effect of certain medications can threaten normal intrauterine development. The main danger of this disease in pregnant women is that the baby may be born with a deficient weight or premature.
Cystitis of pregnant women: complications
Cystitis in the absence of complications does not have a strong effect on the course of pregnancy. But it often serves as one of the first clinical manifestations of much more serious diseases that can cause big problems.
If you self-medicate or ignore cystitis altogether, you can provoke acute pyelonephritis with varying degrees of complications, since the infection from the bladder will inevitably spread up the ureters to the kidneys. Complicated cystitis can lead to miscarriage, artificial termination of pregnancy, and premature birth.
Treatment, prevention
The most effective method of combating cystitis is selected by a doctor based on the results of tests performed by a pregnant woman. The main place in it is occupied by the use of antimicrobials. When choosing a particular drug, the doctor always takes into account the duration of pregnancy and the possible negative effect of the composition of the drug on the fetus being carried.
Preference is most often given to:
antibiotics – most of them are contraindicated during pregnancy, some can be taken under the supervision of a specialist in cases where the benefits exceed the possible risks, but with caution (“Monural”, “Amoxicillin”, “Cephalexin”, etc.);
plant–based uroseptics – have a diuretic, antimicrobial, antispasmodic, anti-inflammatory effect (for example, “Kanefron N”), additionally herbs with a diuretic effect can be prescribed, a decoction of which pregnant women take for a week.
Instillation is used as inpatient treatment, when drugs are injected directly into the bladder through a catheter.
The acute form of the disease lasts five to seven, less often 10-15 days – and this is with timely treatment. If the recovery process is delayed, a more thorough examination is necessary – perhaps there is a concomitant disease that supports the inflammatory process going on in the bladder.
As for the prevention of inflammation of the bladder, it consists in avoiding hypothermia, observing personal hygiene, timely, correct diagnosis, competent treatment of diseases associated with the genitourinary sphere, including acute cystitis.
