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Urinary Tract Infections During Pregnancy

By Lara A. Friel, MD, PhD, Associate Professor, Maternal-Fetal Medicine Division, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Medical School at Houston, McGovern Medical School

Urinary tract infections are common during pregnancy, probably because the enlarging uterus and hormones produced during pregnancy slow the flow of urine in the tubes that connect the kidneys to the bladder (ureters). When urine flow is slow, bacteria may not be flushed out of the urinary tract, increasing the risk of an infection.

Urinary tract infections increase the risk of the following:

Sometimes an infection in the bladder or ureters spreads up the urinary tract and reaches a kidney, causing an infection there (see Postpartum Bladder and Kidney Infections). Bacteria may infect the urine without causing symptoms of urinary tract infections, so doctors usually check the urine for bacteria even in pregnant women without symptoms.

Treatment consists of antibiotics. Doctors choose antibiotics that do not harm the fetus, such as cephalexin, nitrofurantoin, or trimethoprim/sulfamethoxazole. Women who have had more than one bladder infection or have had a kidney infection need to take antibiotics throughout pregnancy to prevent subsequent urinary tract infections.