Urethritis in pregnant women symptoms and treatment. Unexpected discomfort: urethritis during pregnancy. How is urethritis diagnosed during pregnancy?

Key points regarding acute urethritis:

• Acute urethritis occurs as a result of the spread of pathogenic bacteria into the urethra.
• Contact with these bacteria on a newborn can cause him to develop conjunctivitis or pneumonia.
• Left untreated, acute urethritis can lead to complications such as pelvic inflammatory disease.

Acute urethritis involves inflammation and infection of the urethra (urethra). What is the urethra - this is the channel (tube) through which urine is excreted from the bladder to the outside. Urethritis is usually caused by one of three bacteria:

• coli
• gonococci (cause gonorrhea)
• chlamydia (causes chlamydia)

E. coli is one of the many bacteria commonly found in the rectum and vagina. It can enter the urethra during intercourse or when wiping the anus after a bowel movement. Gonococci and chlamydia are transmitted through sexual contact, and are sexually transmitted infections (cause sexually transmitted diseases).

Complications of urethritis during pregnancy

When gonococci and chlamydia are present in the urethra, they are usually found in the cervix as well. In non-pregnant women, these bacteria can cause upper genital tract infections if not treated promptly. One of the most dangerous complications of urethritis in women is pelvic inflammatory disease (PID). Infection with these bacteria during pregnancy may increase the risk of preterm birth.

E. coli or other similar microorganisms, in addition to inflammation of the urethra, can cause cystitis during pregnancy, and infect the kidneys. Kidney infection during pregnancy can lead to premature birth and other complications.

Another complication can occur when a baby passes through an infected birth canal during delivery. The infant may develop serious eye infections due to gonococci or chlamydia present in the birth canal. Chlamydia can also cause respiratory tract infections in a newborn.

Symptoms of acute urethritis in women during pregnancy

Acute urethritis usually causes the following symptoms:

• frequent urge to urinate (need to urinate frequently);
• Urgent urge to urinate (need to urinate immediately)
• indecisiveness (intentional delay in the outflow of urine in the toilet);
• urinary incontinence;
• painful urination;
• burning in the urethra;
• urethra hurts.

When gonorrhea or chlamydia causes urethritis, a woman may experience a white discharge from the urethra during pregnancy or a yellow, purulent discharge. In addition to these symptoms, a woman may also experience discomfort in the urethra during pregnancy.

Diagnostics

Your doctor may examine a urine sample for high white blood cells (WBCs) to help make a correct diagnosis. Your doctor may also take a sample of urethral discharge to help diagnose gonorrhea, if present. The most useful diagnostic procedure for detecting chlamydia in urethral secretions is chlamydia DNA testing.

How to treat urethritis during pregnancy

Treatment of urethritis during pregnancy depends primarily on the cause of its occurrence:

coli

Non-specific urethritis is usually treated with antibiotics, such as:

• Trimethoprim/sulfamethoxazole (Bactrim or Septra)
• Ciprofloxacin
• Nitrofurantoin (Macrobid)

Your doctor may prescribe a 3- or 7-day course of antibiotics.

Gonorrhea or chlamydia

The most cost-effective treatment for gonorrhea is a single dose of cefixime (Suprax) orally or injections of ceftriaxone (Rocephin). Your doctor may also prescribe a single dose of Azithromycin (Zithromax) by mouth for chlamydia.

Pregnant women and patients allergic to penicillin are given one injection of Spectinomycin (Trobicin) to treat gonococcal urethritis (gonorrhea). Other patients allergic to penicillin can treat gonorrhea with a 7-day course of doxycycline (Vibramycin). They may also be treated with quinolones such as ciprofloxacin (Cipro) or Ofloxacin (Floxin). People who are allergic to penicillin can still take azithromycin to treat chlamydia. Your sexual partner should also be diagnosed and treated.

Prevention of acute urethritis

Safe sex using barrier contraceptives is one way to prevent the occurrence of sexually transmitted infections, which also lead to urethritis during pregnancy. Regular testing and check-ups with a gynecologist are also important for your reproductive health. Wiping from front to back after urinating or defecation helps prevent bacteria present in feces from entering the urethra or vagina. You must also keep your body hydrated. To do this, you just need to drink enough water, which will also help your body get rid of bacteria.

Forecast

Treatment of acute urethritis during pregnancy can be without complications if proper treatment is started as soon as possible. Follow your doctor's instructions and take all of your medications as directed. If you are diagnosed with acute urethritis in early pregnancy, you need to tell your sexual partner. This will prevent reinfection and ensure that your partner is also treated.

Let's be honest - urethritis during pregnancy is one of the diseases that the expectant mother would least like to "catch". Not every pregnancy is easy and carefree, and the occurrence of any health problems can darken this period even more. In turn, it is worth noting that a woman may not always be responsible for the appearance of this disease, but this does not reduce the need for its treatment.

In this article, we will talk about the causes and types of urethritis during pregnancy, in addition, we will find out what symptoms it is accompanied by, and what is specifically dangerous at this time, and also consider what methods can be used to combat this disease while expecting a child.

Urethritis itself is an inflammatory disease that affects the urethra. There is a specific and n.

The causative agent of specific inflammation, chlamydia, mycoplasma, Trichomonas, fungi of the genus Candida, and staphylococci, streptococci, Escherichia coli and others are responsible for nonspecific inflammation.

Most likely, infection occurs during unprotected intercourse, but factors such as:

• urethral injury;
• frequent physical activity that causes severe fatigue;
• changes in the hormonal background and microflora of the vagina;
• irregular urination;
• urolithiasis disease;
• the use of copious amounts of fatty, salty, spicy and sour foods;
• insufficient amount of liquid consumed;
• medical manipulations with the urethra;
• existing infectious and inflammatory diseases of the genitourinary system;
• hypothermia;
• defects of the genitourinary system;
• food allergy;
• non-observance of basic rules of personal hygiene.

Urethritis in women during pregnancy can develop due to a growing fetus that compresses the urethra and pelvic organs.

Clinical picture of the disease

The manifestations of the disease during the period of bearing a child do not differ in any way from the symptoms in non-pregnant women. The incubation period can last from 7 to 30 days, depending on many factors and the general health of the expectant mother as a whole.

The main symptoms are:

1. The appearance of sharp pain, itching and burning during urination.
2. The appearance of a large amount of mucopurulent or purulent discharge with an unpleasant odor, the color of which can be from yellowish to green.
3. Redness and swelling both in the urethra and on the external genitalia.
4. Increased urge to urinate, and in some cases the need to urinate urgently, and urinary incontinence.

Complications during childbearing

There is a fairly significant number of various complications caused by urethritis, however, at the time of pregnancy, not only the mother's body, but also the body of the unborn child is sensitive to them. Any doctor knows that complications of infectious diseases can seriously affect the health of the unborn baby.

The disease can cause severe fetal pathologies, intrauterine death or premature birth. The most common causes of such complications are gonococci, chlamydia and ureaplasma. The risk of threatened abortion and placental insufficiency is very high, due to which the infection can infect the child.

Options for diagnosis and treatment of the disease

Since all pregnant women regularly visit a gynecologist, the disease can be detected in a short time. Based on the patient's complaints, the specialist will ask questions of interest to him, conduct an examination, and also issue a referral for the necessary tests.

It could be:

1. Microscopic examination of a smear- material is taken from the urethra and its appearance is evaluated, namely the presence of leukocytes, mucus, epithelium and microorganisms.
2. Bakposev for the detection of microorganisms and sensitivity to antibiotics - they take the material and determine the qualitative and quantitative composition of the microflora in the test material, identify pathogenic bacteria. If high titers of opportunistic microorganisms or the presence of pathogenic species are detected, their sensitivity to antibiotics is established.
3. ultrasound organs of the genitourinary system.
4. Urinalysis- it can be both OAM and a three-glass sample.
5. PCR - diagnostics- this method allows you to identify the DNA of pathogens in any form and quantity, using for these purposes not only secretions, but also blood or urine. The price of such an analysis is on average 500 rubles.

Important! Treatment of urethritis in pregnant women is mandatory, since without this the disease can lead to severe consequences for the fetus and mother.

Naturally, for the purpose of drug therapy, antibacterial drugs are used, which are as safe as possible for the unborn child.

Depending on the type of pathogen, treatment can be carried out:

• josamycin;
• erythromycin;
• amoxicillin;
• ceftriaxone;
• cefixime;
• spectinomycin.

In addition, the use of local treatment (ointments, creams, gels, urethral lavages), vitamin therapy, immunostimulants and probiotics is recommended. The instruction in many antibacterial drugs warns of the possible risks of their use, or the lack of data on use during gestation. In such cases, you can safely contact your doctor, as he is well aware of the real risks of using a particular medication.

From the photos and videos in this article, we became aware of the features of urethritis during pregnancy, as well as the existing treatment options for this disease.

Frequently asked questions to the doctor

I don't want to be treated

Good evening. Tell me, how mandatory is the treatment of urethritis during pregnancy? I would not like to resort to antibiotics, as I am afraid that they can negatively affect the baby.

Hello. Urethritis needs to be treated. Without the necessary and proper treatment, the disease will develop into a chronic form, and as a result, the infectious focus will expand and microorganisms will penetrate the vagina and bladder, and the infection will begin to develop in an ascending type, eventually causing complications that are dangerous for the unborn child.

The development of urethritis occurs against the background of pathogenic and conditionally pathogenic flora entering the urethra.

During pregnancy, this phenomenon often happens, this is due to the characteristics of the female body during this period. Therapy is carried out only under the supervision of the attending physician.

Why the disease develops

Urethritis during pregnancy occurs for infectious and non-infectious reasons. It often develops when microorganisms spread into the urethra.

When examined in women, Escherichia coli, streptococci or staphylococci are isolated. Specific inflammation develops against the background of spread into the canal:

1. Mycoplasma infection.
2. Trichomonas, chlamydia.
3. Ureaplasma infection.
4. The causative agent of gonorrhea.
5. Herpes simplex virus type 2.

These infections enter the urinary system only through unprotected sexual contact. In this case, a pregnant woman often develops lesions of the genital organs.

Features of the female body during pregnancy

Pregnancy is accompanied by changes in the functioning of organs and systems. With the development of the fetus, the hormonal background of the woman is the first to be rebuilt. Hormones are produced that are responsible for the normal course of pregnancy, the formation of the secret of the mammary glands.

The work of the thyroid gland and adrenal glands is rebuilt. In a different rhythm, the gastrointestinal tract begins to function.

Sometimes women have anemia due to iron or vitamin B12 deficiency. The importance is given to the initial level of a woman's health.

Some doctors describe that in this position a woman develops some kind of immunodeficiency.

Associated with the changes mentioned above, with a lack of vitamins, nutrients. As a result, the female body becomes vulnerable to infections and diseases.

The exception is not urethritis, which is recorded in 20% of cases. When the first signs appear, a woman should immediately consult a doctor for help, there are complications of the disease that affect the health of the mother and unborn child.

How to determine urethritis

Symptoms of pathology in pregnant women are either bright in color or go unnoticed. Manifestations depend on the type of microbe that caused the disease.

Symptom complex of nonspecific urethritis:

1. Slight pain during urination.
2. The appearance of itching or burning in the urethra.
3. There is redness, swelling of the skin around the canal.

In general, the woman feels satisfactory, which reduces the likelihood of timely diagnosis of the disease.

The intensity depends on the immune system. If urethritis develops acutely and is accompanied by severe manifestations, then the signs are different:

1. There is a sharp pain at the time of urination.
2. The pain radiates to the groin or lower back.
3. Mucous discharges are observed.
4. Urine becomes cloudy.

Urinary incontinence is sometimes noted. In the acute stage, a pregnant woman notes weakness, malaise, drowsiness.

Urethritis with late treatment becomes chronic. Manifested by a decrease in the intensity of symptoms. Characteristic:

1. Discomfort in the urethra when passing urine.
2. Urination disorders in the form of pain.
3. Frequent trips to the toilet.

The drug is selected taking into account the type of pathogen. If the cause is an STI, then drugs that are active against these infections are used.

The development of urethritis during pregnancy requires treatment that enhances immunity. This aspect is given importance from the first month of fetal development.

Often women are prescribed vitamin and mineral complexes. They make the following recommendations:

1. Spend at least 2 hours a day outdoors.
2. Do yoga or other type of exercise allowed in the position.
3. Add fruits, vegetables, juices to your diet. Limit the intake of light carbohydrates in the form of chocolate or other sweets.
4. Follow personal hygiene. To toilet the external genitalia several times a day, without the use of soap. It is recommended to use special tools.
5. Use barrier contraception when having sex with a new partner.

Treatment of urethritis is carried out by a doctor after a series of special examinations. Attention is paid to the prevention and reduction of the risks of developing pathology.

What is dangerous urethritis in position

Considering the issue, consider a few points:

1. Infection of the urinary system in women tends to spread upwards.
2. Relapse occurs in 50% of cases.
3. The inflammation is complicated by a number of life-threatening conditions.

A pregnant woman is no exception to the general rule. A weakened body can not cope with the load.

For this reason, often with urethritis, the infection quickly rises to the bladder, which leads to the development of cystitis.

This pathology is characterized by acute and unbearable pain during urination, the appearance of pain in the lower abdomen.

Following cystitis, against the background of a weakened immune system, there is a risk of infection in the kidneys. In this case, pyelonephritis develops, which is a serious illness for a person.

In addition to a number of complications, the addition of urethritis for a pregnant woman can result in early labor or miscarriage. The development of events will depend on the type of microorganism that caused the urethritis.

In clinical practice, there are examples when Escherichia coli is found in the cerebrospinal fluid of newborns, this causes the development of meningitis in a child.

Therefore, pregnant women are required to carefully monitor their health and seek help in time. It is better to do a lot of analysis and research than to expose the unborn child to dangers.

Video

Many pregnant women experience burning during bladder emptying. To identify the cause and eliminate the trouble, you need to consult a doctor.

Burning during urination during pregnancy is sometimes associated with a change in the functioning of the excretory system. In the later stages, the uterus with the fetus squeezes the urinary canals, which causes discomfort.

But more often in women who are carrying a child, chronic problems of the genitourinary system worsen: stones and other pathologies. If you have a burning sensation at the time of visiting the toilet, you should contact a gynecologist so that he can help you find the cause of discomfort and prescribe treatment.

Burning sensation when urinating in pregnancy

Burning and pain during urination during pregnancy worries many women, especially in the later stages (in the second and third trimester). Unpleasant sensations are explained by the changed physiology, occur due to the fact that the volume of fluid increases.

Discomfort also occurs due to compression of the urethra and bladder by the uterus with the fetus. During pregnancy, due to hormonal changes, the composition of the natural microflora of the intestines and vagina is disturbed. The immune defense of these organs is reduced.

Less commonly, cramps, pain and itching during urination appear for other, pathological reasons:

• exacerbation of chronic diseases of the genitourinary system (cystitis, and pyelonephritis);
• infections in the urinary tract or kidneys;
• development or exacerbation of urolithiasis.

Pathological causes of discomfort

Changes in hormonal levels, decreased immunity and stress on the genitourinary system in pregnant women exacerbate chronic infections: cystitis, urethritis and pyelonephritis. Pathogenic bacteria, "dormant" in the bladder, urethra or kidneys, begin to multiply more actively. Because of this, inflammation develops, and the waste products of microorganisms increase it.

Without timely therapy, the infection gives complications: it threatens the bearing of a child, makes it difficult for the mother to recover after childbirth.

Infections of the genitourinary system are not only in women with a history of chronic diseases. Chlamydia, ureaplasmosis, can be acquired through unprotected intercourse. It is easy to get infected through common household items with sick people, as well as ignoring the rules of intimate hygiene. In this case, fungi, Escherichia coli are especially dangerous.

Urolithiasis often develops in pregnant women during the gestation period, but disappears after childbirth. It progresses due to disturbances in the production of urine and its excretion from the body. In the later stages, burning after urination, cramps and pain in the lower abdomen often torment women with this pathology.

Cystitis in pregnant women and its symptoms

Separately, it is worth talking about cystitis in pregnant women, which often accompanies the bearing of a child. Two factors contribute to its development: hormonal changes and stagnation in the bladder. In the first case, due to a shift in the work of the endocrine system, the composition of the natural flora in the body is disrupted, and the risk of pathogenic bacteria joining increases.

The second provocateur of cystitis is the stagnation of urine. During pregnancy, the bladder does not throw out all its contents. The functioning of the organ is disrupted by the growing uterus. Urine, which does not leave the bladder for a long time, becomes an ideal breeding ground for microbes, irritates its walls, provoking inflammation.

The main manifestations of cystitis are:

• cramps or discomfort (heaviness, overcrowding in the lower abdomen);
• burning after urination in the area of ​​​​the bladder or urethra;
• frequent urge to urinate;
• with advanced cystitis -;
• cramps in the muscles of the lower back or lower abdomen;
• with an unpleasant odor, impurities of blood or pus.

Diagnostics

Burning, discomfort in the urinary tract or pain after urination in the lower abdomen during pregnancy, aching lower back, urethra or vagina - any type of discomfort requires immediate consultation with a doctor. Without timely examination, the disease will progress, and complications may appear during pregnancy.

Diagnostic procedures are selected by the attending gynecologist after an external examination. To find out the causes of discomfort during urination in pregnant women, the following methods will help:

• PCR of a biological sample from the urinary canal and vagina (to identify infectious agents);
• Ultrasound of the pelvic organs;
• cystoscopy;
• blood chemistry;
• quantitative sample of urine, blood;
• smear for STIs (genital infections).

How to get rid of burning sensation when urinating

Treatment depends on the cause of the pain in the lower abdomen during pregnancy. For example, if there is an infection in the urinary tract or bladder, the patient is given a course of antibiotics, but their choice is limited by the position of the woman. Three classes are safe during the gestation period:

• macrolides;
• penicillin preparations;
• cephalosporin series.

With a viral or fungal infection, antiviral or antifungal drugs are prescribed, as well as local antiseptics.

If the pain after urination is provoked by sexual infections, then in addition to medicines for oral administration, vaginal suppositories may be prescribed.

It is important not only to eliminate the cause of discomfort, but also to improve the patient's well-being. To do this, use other drugs (symptomatic therapy). If the lower abdomen hurts, and the nature of the discomfort resembles contractions, the doctor may prescribe antispasmodics; when the sensations are not bright, a mild painkiller is prescribed.

In addition to taking medications, you need to drink more water to quickly clear the urinary tract from infection, if any. This can be done by taking additional herbal remedies with a diuretic and anti-inflammatory effect. Teas made from chamomile, horsetail and other herbs work well.

Pain and discomfort during urination in pregnant women occurs for various reasons, for example, due to infections of the urinary tract, genital tract, or stones in the kidneys. Burning in the lower abdomen is often caused by cystitis, which progresses without treatment, which increases the risk of complications.

To make a diagnosis, you need to visit a doctor and undergo a course of diagnostic procedures. Treatment should be prescribed by a specialist, since during pregnancy the choice of drugs should be given special attention. Expectant mothers are allowed to take only 3 classes of antibiotics, and most painkillers and anti-inflammatory drugs do not suit them at all.

Urethritis is an inflammatory process that affects the mucous membranes of the urethra. It occurs as a result of infection with pathogenic microorganisms, allergies or injury.

Often the disease occurs in women expecting the birth of a child. The main factor influencing the development of urethritis in pregnant women is a change in the hormonal background, as a result of which the body's defenses weaken. Urethritis during pregnancy requires treatment, since any infection that enters the mother's body negatively affects the fetus.

Causes of inflammation in pregnant women

Urethritis is divided into venereal (specific) and non-venereal (nonspecific). In the first case, the infection enters the body of a pregnant woman through sexual contact. Cause a specific form of the disease can:

• Neisseria gonorrhoeae (gonorrhea).
• Trichomonas vaginalis (trichomoniasis).
• . (hdamydia).
• Human papillomavirus (human papillomavirus).
• Candida (fungi of the genus Candida).

With the development of a nonspecific form of the disease, the pathogen enters from the focus of chronic inflammation, moving through the blood or lymph. The disease can be caused by:

• Streptococcus (streptococci).
• Escherichia coli (E. coli).

Factors contributing to the development of urethritis

Non-infectious urethritis in pregnant women can be caused by the following reasons:

• Chronic constipation.
• Genital trauma.
• Active sexual relationship.
• Allergic reaction.
• A metabolic disorder, resulting in an increase in the amount of phosphates or urates in the urine.
• Urolithiasis, in which the mucous membrane is damaged by passing stones.
• The appearance of tumors in the urethra.
• Gynecological diseases.

Note! The appearance of urethritis in pregnant women can be facilitated by such factors as a decrease in immunity, chronic inflammation of the pelvic organs, hypothermia, drinking insufficient amounts of fluid, or violations of personal hygiene.

Symptoms of the disease

Urethritis is a rather insidious disease, its symptoms may be insignificant and differ depending on what exactly provoked the disease.

Allergic urethritis can appear within a couple of hours after contact with an irritant. The incubation period for the bacterial form of urethritis can range from 3 days to 10 weeks. It develops 7 days after infection with gonococcus and 10 days after Trichomonas enters the body. After infection with chlamydia, mycoplasma, or viruses, it may take several months for symptoms to appear.

Common symptoms of urethritis include:

• Pain during the act of urination, which does not disappear after it is completed.
• Burning and itching in the process.
• Redness and swelling in the vulva.
• Allocations (in some cases purulent).
• Periodic aching pain above the pubis.
• The presence of blood and pus in the urine.
• After sleep, there is a feeling that the urethra sticks together.

Note! Symptoms may appear all at once, with some being more severe. With an exacerbation of a chronic disease, they may be completely absent, then the disease will be detected only during a gynecological examination.

With infectious urethritis, its course and the severity of symptoms may differ:

• If Trichomonas becomes the causative agent of the disease, burning and itching of the genital organs become a specific symptom.
• When the disease is caused by gonococcus, there is pain in the urethra if going to the toilet is delayed.
• Chlamydia provoke purulent discharge.
• The fungus as a provocateur is indicated by unpleasant sensations during the exit of urine and white-pink viscous discharge from the urethra.

Note! In the chronic form, signs are mild itching and burning during a trip to the toilet or the appearance of a few drops of pus from the urethra.

Why is urethritis dangerous?

Non-infectious urethritis during pregnancy in most cases is not dangerous for the unborn baby. At the same time, inflammation can move up and provoke cystitis, colpitis or pyelonephritis.