Urinary Tract Infections (UTI)

Urinary tract infections during pregnancy are very common. They occur in approximately 1 in 10 pregnancies.

Symptoms of a urinary tract infection:

• Urinating more frequently than normal
• May have the urge, but can not urinate
• Burning sensation while urinating
• May have sharp pains while trying to urinate

Note: If you have fever, blood in urine, chills, or back pain, you could have an infection that has reached the kidneys (kidney infection), Please contact your doctor.

How a urinary tract infection is detected:

A urinary tract infection can be detected at the doctor's office or at home. Both tests use a sample of your urine and detects bacteria in the urine. You can purchase a UTI kit in the pharmacy of your local drug store.

What to do if you have a urinary tract infection:

If you have any of the symptoms above, contact your doctor. The doctor may put you on an antibiotic that you should take until completely finished with the medication. Urinary tract infections during the last trimester can become very serious. It could cause pre-term (early) labor by bringing on contractions of the uterus.

How to prevent a urinary tract infection:

• Drink lots of fluids
• Make sure you completely empty your bladder when you urinate
• Eat yogurt (unsweetened)
• Wear cotton panties (more breathable)
• Avoid bubble baths
• Avoid perfumed toilet tissues
• Wipe from front to back
• Empty bladder before and after sexual intercourse

Placenta Previa

Placenta Previa (also known as low lying placenta) is the condition where the placenta is attached near the opening of the cervix. The possibility of delivering the placenta before the baby, poses a risk for the mother hemorrhaging.

Placenta praevia (placenta previa AE) is an obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix. It can sometimes occur in the later part of the first trimester, but usually during the second or third. It is a leading cause of antepartum haemorrhage (vaginal bleeding). It affects approximately 0.5% of all labours. Source: Wikipedia

Placenta previa can be divided into four types, of which the first two are the most common:

1. the placenta is positioned low in the womb, but the baby can still be born vaginally.

2. the lower edge of the placenta touches the opening of your cervix, but does not cover it, so the baby can be born vaginally.

3. the placenta partially covers the opening of your cervix. The baby will need to be born by caesarean section.

4. the placenta completely covers the opening of your cervix. The baby will need to be born by caesarean section. 

Pre-term (Premature) Labor

Pre-term (Premature) labor is childbirth that begins before the baby is ready. This type of labor occurs between the 20^th and 37^th week of pregnancy. If you begin to have signs of premature labor before the 20^th week it is termed a miscarriage. If you begin to have signs of labor after the 37^th week it is termed a full-term labor.

Signs of Premature labor:

• Cramping (menstrual like) with/without diarrhea
• Lower backache
• Discharge (watery/pinkish/brownish)
• Passing Gelatin like material (mucus plug)
• Trickle or Gush of amniotic fluid (Rupture of Membranes)

Note: If you have any of the signs above, please call your doctor.

The doctor may be able to stop early labor with Tocolytic (a medication that relaxes the uterus and prevents contractions). 

The doctor may also have you do the following:

• Stop physical activities (including intercourse)
• Bed rest

If the doctor believes labor is a likely possibility, they may give you corticosteroids to speed the development of the baby just in case labor begins. 

Things that may cause Pre-term (premature) Labor:

• Drinking alcohol
• Smoking cigarettes
• Recreational type drugs (i.e. marijuana)
• Not eating right
• Not gaining enough weight (at least 20-25 pounds)
• Under the age of 17 (body is still growing)
• Over the age of 35 (body needs extra nutritional needs)
• Pregnant with Multiples (i.e. twins) often times delivers 3 weeks earlier
• Standing a lot
• Incompetent Cervix (cervix fails to stay closed)
• Placenta Previa (May have to have complete bed rest)
• High levels of stress
• Holding off urinating (always go to the bathroom when needed)
• History of premature labor
• Sexual Intercourse (may cause some women to have contractions)

Anemia

Anemia during pregnancy is a condition in which the red blood cells are depleted. These red blood cells are responsible for your energy level as well as oxygen carried in the blood stream. This is why you may feel dizzy, tired and out of breath.

Symptoms of Anemia:

• Extreme fatigue
• Weakness
• Pail skin
• Dizziness
• Out of Breath
• Heart Palpitations

Note: If you do not have any of the symptoms above and you just feel more fatigued than usual or feel something is wrong, talk with your doctor.

Most Common time period for women to become anemic:

Around the 20^th week, some pregnant women become anemic. This is due to the increase in blood flow and the increase in need for iron. Women who are anemic before pregnancy may continue to have problems during their pregnancy.

What foods can help Iron levels?

• Liver (eat on occasion)
• Beef
• Beets
• Sardines
• Oysters (cooked)
• Spinach
• Dried Fruits
• Soy Products
• Beans & Peas
• Pumpkin

Bleeding during Pregnancy

Bleeding during pregnancy is always cause for some degree of concern. Sometimes this may be implantation bleeding, a period after pregnancy, sign of miscarriage, bloody show at a full-term pregnancy, pre-term labor or problems with the placenta.

Note: Always contact your doctor if you experience any bleeding or spotting (very light bleeding) during pregnancy.

Implantation Bleeding:

This type of bleeding is usually in a very small amount and occurs when the embryo is attaching to the lining of the uterus. Some women may think they are starting their period, but then realize they were only lightly spotting or having implantation bleeding. Around 7-10 days after conception, is when implantation bleeding usually occurs and is not accompanied with lower abdominal pain. Many women do not have this type of bleeding.

Menstrual Cycle after pregnancy:

Sometimes women have a period after they have conceived. Sometimes this is a pattern passed from their mother. This period may be like a normal period or may be a little lighter than normal. This is why some women do not know they are pregnant until the next month when they do miss a period.

Signs of a miscarriage:

Bleeding during pregnancy is unfortunately also a sign of a possible miscarriage or pending miscarriage.

Some signs of a possible miscarriage or pending miscarriage are:

1. cramping in the center of your abdomen (low)
2. pain without bleeding that is severe or lasts for more than one day
3. bleeding that is heavy (like a period) or spotting that lasts for more than three days.
4. History of miscarriages
5. You soak several sanitary napkins (pads) in a one hour period
6. If you pass gray or pink material or clots. (save anything like clots to take to the doctor).

What you should do if you suspect a miscarriage:

1. Call your doctor or immediately go to the emergency room or doctors office.
2. Lay down and rest if you are waiting for help or if your doctor suggests that you wait.

Bloody Show (full-term pregnancies):

If you are experiencing bleeding or spotting around the 40^th week of pregnancy, this could be called bloody show. This is when you are losing your mucus plug and is usually pinkish or very light colored mixed in with a mucus discharge. This also means that childbirth may occur within 24 hours (sometimes a few days).

Signs of Pre-term (premature) labor:

Pre-term labor bleeding is usually characterized by being light pink or brownish in color. The woman may feel signs of labor during this time.

Problems with the Placenta:

Bleeding may occur if you have abnormalities of the placenta. If you have conditions such as placenta previa, you may experience bleeding. This is due to the placenta pulling away from the area of the cervix. Usually bleeding will occur around the 34^th to 38^th week if at all.

Pre-Eclampsia/Eclampsia

Pre-eclampsia and eclampisa are the medical condition of high blood pressure (Pregnancy-Induced Hypertension) during pregnacy. This condition is most often present in first time pregnancies.

Pre-eclampsia is the beginning stage of eclampsia. It is very rare for pre-eclampsia to elevate to the next stage of eclampsia unless you are not seeking medical care. Pre-eclampsia/eclampsia occur in 5% to 10% of pregnancies.

The most common cause for pre-eclampsia/eclampsia is when the mother becomes pregnant and has chronic high blood pressure prior to conception.

Symptoms of Pre-eclampsia:

• Swelling of hands and face
• Sudden weight gain (excessive)
• High blood pressure (140/90 or higher)
• Protein in urine

 Severe Pre-eclampsia:

• 160/110 or higher blood pressure
• blurred vision
• headaches
• itching (everywhere)
• Very little urinating
• Confusion
• Severe pain (gastional)

This condition (pre-eclampsia/eclampsia) will occasionally appear during labor, delivery or postpartum.

Danger signs that warrant immediate medical attention:

• Severe headache
• Visual disturbances

• Abdominal pain

Treatment:

Mild pre-eclampsia:

• If you are near term and your cervix is ripe, your doctor may induce your labor.
• Lay on your left side when bedrest.
• Reduce sodium (drastically)

Usually you will not be allowed to go past your due date. The doctor will either induce unless you begin labor before 40 weeks.

After delivering, your blood pressure should return to normal unless you have chronic hypertension. This usually occurs 24 hours after birth, but sometimes within a week after giving birth.

Eclampsia (developed after pre-eclampsia):

• Vomiting or nausea
• Severe headache
• Very high levels of protein in urine
• Dramatic increase in blood pressure
• Abdominal pain (upper)
• Visual disturbances
• Drowsiness
• Fever
• Rapid heartbeat

Convulsion and Coma follow these danger signs of eclampsia.

Labor will be induced or a cesarean will be performed.

Pregnant with Multiples (Twins or more)

Carrying multiple fetuses (twins or more) places the pregnancy into a higher risk pregnancy category than carrying single fetuses.

Women who are carrying multiple fetuses have an increased risk for the following things:

• Pre-term Labor
  
• Pre-eclampsia
  
• Anemia
  
• Urinary Tract Infections
  
• Vaginal Bleeding
  
• Placenta Previa

Increased Doctor's Visits:

After the 20^th week, you may find yourself visiting the doctor more frequently than women who are pregnant with just one fetus. The doctors may want to check you often to ensure a safe and healthy pregnancy. If you work, you may have to cut down. Doctors usually recommend increased bed rest also.