A urine infection means having germs (bacteria) somewhere within the urinary tract, ie the bladder, kidneys or the tubes between (the ureters). In pregnancy, a urine infection is more likely to cause complications, and so usually needs treatment.
Most women are, unfortunately, familiar with the typical symptoms of a urine infection. You feel as though you are busting for a pee all the time. But when you go to the loo, only a dribble comes out and it burns or stings when it does. There may be an ache in the lower part of your tummy (abdomen) too. However, urine infections don't always cause symptoms, particularly in pregnancy. Sometimes it is only picked up during one of the routine tests of your urine.
If the infection spreads up your urinary tract towards your kidneys, the symptoms change. You may get back pain and/or a high temperature (fever). There may be blood in your urine.
How did I get it?
Normally, there are no germs (bacteria) in urine. However, if you have a urinary infection, the germs from elsewhere in your body have made their way up the urinary tract. These are usually germs from your guts - after all, the exit points for poo and wee in your body are particularly close together. After doing a poo, some of those germs can end up on the skin between the two, and make their way from there to the urine tube (urethra).
Germs then travel up the urethra, which leads to the bladder, and may spread further up the next set of tubes (ureters) to your kidneys. Because women don't have a penis, the tube between their bladder and the outside world is much shorter than that of a man. This makes women more prone to urine infections.
When you are pregnant, you are even more prone to urine infections. This is partly because of changes caused by your pregnancy hormones and partly because your enlarged womb (uterus) is squashing your bladder, so it doesn't empty as effectively as it usually does.
Why is it different in pregnancy?
A urine infection in pregnancy is more likely to cause complications than it is in somebody who is not pregnant. If you have a urine infection, you are more likely to go into labour early, and more likely to have a smaller baby. In pregnancy the germs (bacteria) are more likely to spread towards your kidneys, giving you a more serious infection called pyelonephritis. For these reasons, if germs are found in your wee in pregnancy, you would normally be advised to take a course of antibiotics, even if you have no symptoms at all.
Fortunately, antibiotics are usually very effective at clearing the infection up, thereby preventing any of these problems.
Further reading and references
Management of suspected bacterial urinary tract infection in adults; Scottish Intercollegiate Guidelines Network - SIGN (updated July 2012)
Guidelines on Urological Infections; European Association of Urology (2015)
Urinary tract infection (lower) - women; NICE CKS, July 2015 (UK access only)
Vazquez JC, Abalos E; Treatments for symptomatic urinary tract infections during pregnancy. Cochrane Database Syst Rev. 2011 Jan 19(1):CD002256. doi: 10.1002/14651858.CD002256.pub2.
Schneeberger C, Geerlings SE, Middleton P, et al; Interventions for preventing recurrent urinary tract infection during pregnancy. Cochrane Database Syst Rev. 2012 Nov 1411:CD009279. doi: 10.1002/14651858.CD009279.pub2.
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