Pregnant women are at increased risk for UTIs. These factors may all contribute to the development of UTIs during pregnancy.
Most pregnant ladies (50-70%) have bacteriuria but it is asymptomatic, until it progresses into PYELONEPHROSIS.
Pyelonephrosis is serious because it can cause abortion, pre-term labour or low birth weight.
Beginning in week 6 and peaking during weeks 22 to 24, approximately 90% of pregnant women develop ureteral dilatation, which will remain until delivery (hydronephrosis of pregnancy).
1) Hormonal changes
This is due to the increased progesterone hormone in pregnancy. Progesterone will decrease the muscle tone (in bladder and ureters).
Therefore, the urine will take longer time to pass through the urinary tract = causing stagnation.
Increased bladder volume and decreased bladder tone, along with decreased ureteral tone, contribute to increased urinary stasis and ureterovesical reflux.
Stasis of urine gives more time for the bacteria to multiply hence increases chance of infection.
2) Anatomical changes
The uterus is anatomically situated above the bladder, thus enlargement of the uterus (due to growth of the baby) will put pressure on the bladder and partially block the ureters.
Hence, pregnant ladies have some kind of obstruction of their urinary tract, which can lead to stasis and infection too.
3) Gestational diabetes
Up to 70 percent of pregnant women develop glycosuria, which encourages bacterial growth in the urine.
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