Treating yeast, UTIs during pregnancy

All Woman

YEAST infections and urinary tract infections (UTIs) are some of the most common infections affecting women during pregnancy.

According to obstetrician-gynaecologist (Ob-Gyn) Dr Anna-Kay Taylor Christmas, most women have or will experience one of these infections in their lifetime, often more than once.

She said women in general are more prone to UTIs because of the anatomy of the urethra, and this is emphasised even more by the hormonal changes in pregnancy which cause more urine to be retained and remain longer in the urinary tract.

Dr Taylor Christmas explained that although most UTIs arise and remain in the bladder, in pregnancy there is an increased risk of the infection rising up to affect the kidneys — pyelonephritis.

“A simple bladder infection may cause more frequent urination, sometimes accompanied by pain and burning or blood seen in the urine. Pyelonephritis tends to cause more serious symptoms including back pain, fever, vomiting, and decreased appetite,” she said.

As a result, at each clinic visit the mother-to-be's urine is checked, and the Ob-Gyn will screen for signs of infection.

Dr Taylor Christmas said if an infection is suspected, then a urine culture ( a sample of urine) is taken and sent to the lab to check which specific bacteria are causing the infection.

“A pyelonephritis can be quite serious and can even lead to a dangerous bacterial infection in the blood, as well as pre-term labour and low birth weight. Even if there are no symptoms, once a bacterial infection is detected in the urine in pregnancy, it will be treated. Therefore, whereas bladder infections can be treated with simple antibiotic tablets in pregnancy, pyelonephritis requires admission to hospital and administration of intravenous antibiotics for a few days to prevent damaging and potentially life-threatening consequences,” she said.

Regarding prevention and treatment of this condition, Dr Taylor Christmas said the chance of getting a UTI can be decreased by drinking lots of water throughout the day, emptying the bladder regularly (especially after intercourse), ensuring good perineal hygiene by wiping from front to back, and maintaining an overall healthy lifestyle with a balanced diet and regular exercise.

If symptoms are suspected, however, she said the woman should go to the clinic right away, as the earlier an infection is treated, the less the risk to mother and baby.

Meanwhile, on the matter of vaginal yeast infections, the Ob-Gyn said the occurrence of this condition increases in pregnancy due to the effect of the hormonal changes on the vagina.

“The symptoms tend to be the same as in the non-pregnant, with vulvo-vaginal itching, redness and irritation and a thick, whitish discharge. There may also be a burning sensation on the vulva when passing urine, and intercourse may be painful,” she explained.

Fortunately, Dr Christmas said a simple yeast infection has not been found to have any long-lasting or negative effects on the pregnancy or the baby.

She said treatment is primarily topical (creams, gels and inserts) as most oral medications for yeast are not categorised as safe in pregnancy.

As the growth of yeast is promoted in a warm, moist environment, she pointed out that other lifestyle changes are also important to prevent frequent or recurrent yeast infections during pregnancy.

“These include wearing well-fitted cotton underwear (the natural fibres tend to cause less sweating), avoiding thong underwear, changing out of wet clothes quickly after any swimming or physical activity, drinking lots of water and maintaining a healthy weight through balanced diet and regular exercise. Having good control of other illnesses, in particular those that suppress the immune system (such as diabetes), is also crucial to preventing recurrent yeast infections,” she said.

However, if there is a severe infection that is resistant to typical treatment, Dr Christmas said more investigations will have to be done to check the type of yeast, as well as to look for underlying illnesses in the mother that could be contributing factors

“The safest possible medication for mother and baby is always used to balance the risk of infection with the treatment. Early treatment and adjusting lifestyle habits tend to be effective in clearing yeast infections for most pregnant women,” Dr Taylor Christmas said.

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