Urinary and Vaginal Problems in Pregnancy

Yeast infections (candidiasis)

During pregnancy, an increased vaginal discharge is normal. However, if the discharge is creamy and thick, and you have some soreness and itching in your vaginal area, you may have yeast, a fungal infection. If you have a vaginal discharge with an odor, you could have trichomoniasis or bacterial vaginosis, which are sexually transmitted infections that can lead to premature delivery if not treated with antibiotics. You are more prone to yeast during pregnancy, particularly during the third trimester.

Causes

A yeast infection is caused by a fungus called Candida albicans. The organism exists normally in small numbers in the intestines and vagina, and doesn't cause problems. However, during pregnancy, the environment in the vagina changes, causing overgrowth of the fungus. If you are under stress, feeling generally unwell, taking antibiotics, or have diabetes, you may be more likely to develop a yeast infection.

What to do

If you think you have a yeast infection, contact doctor, who can take a vaginal swab to confirm the diagnosis. He or she may recommend an over-the-counter vaginal cream. Yeast infections can be harder to control during pregnancy, and may take up to two weeks to go away. To prevent additional infections, wear cotton underwear and always wipe from front to back after a bowel movement.

Stress incontinence

If you have stress incontinence, you pass small amounts of urine unintentionally, particularly when coughing, sneezing, or laughing, and when exercising or lifting heavy objects. Stress incontinence can happen at any time during pregnancy, but is most common in the last trimester.

Causes

The pelvic floor muscles are under additional strain during pregnancy and are also affected by hormonal changes. Therefore any increase in abdominal pressure caused by coughing, sneezing, laughing, or other activities that puts these muscles under pressure may result in leakage of a small amount of urine.

What to do

Stress incontinence can be embarrassing and distressing; however, you should mention the problem to your doctor who will be able to advise you on Kegel exercises (see Start squeezing!), which should help reduce the problem if you practice them regularly. It's important too to empty your bladder whenever you need to. You may want to wear a sanitary pad for additional reassurance.

Urinary tract infections

During pregnancy, you're more susceptible to urinary tract infections. Most commonly, such infections are confined to the bladder, when they are known as cystitis. Symptoms of cystitis include a frequent, urgent need to urinate and a painful burning sensation when passing urine; there may be some blood in your urine. Occasionally, an infection can travel up from the bladder to the kidneys. In this case you may also have pain in your lower back on one side (over the kidney area), have a high temperature, and may feel nauseous or vomit. Sometimes a urinary tract infection is present but causes no symptoms. Prompt treatment of urinary tract infections is especially important in pregnancy because if an infection reaches the kidneys, it can trigger early labor.

Causes

Urinary tract infections are caused by bacteria entering the body through the urethra (the outlet from the bladder) and multiplying. Such infections are probably more common during pregnancy because the effect of hormones on the urinary tract slows the passage of urine.

What to do

If you have any symptoms of a urinary tract infection, see your doctor right away. The doctor will take a mid-stream urine sample and the sample will be sent to a laboratory to identify the type of bacteria that is causing the infection. Your doctor may prescribe a seven to ten day course of antibiotics that are safe for both you and your baby. Symptoms usually improve in a few days after the start of treatment. Because some urinary tract infections are asymptomatic, all pregnant women have urine tests at prenatal doctor's visits, and if bacteria are found, appropriate antibiotics are prescribed.