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Pathophysiology of Urinary Tract Infections in Pregnancy

Urinary tract infection is the presence of pathogenic micro-organisms in the urinary tract, with or without signs and symptoms. (Brunner & Suddarth 2001)

Urinary tract infections can occur in the upper urinary tract (pyelonephritis), or at the bottom (cystitis, urethritis).

Urinary tract infections (UTIs) during pregnancy are relatively common and can pose risks to both the mother and the developing fetus if left untreated. Here are some key points to consider:
 

Causes:

  • Hormonal Changes: During pregnancy, hormonal changes can make women more susceptible to UTIs.
  • Physical Changes: As the uterus expands, it can put pressure on the bladder, leading to difficulty emptying it completely and increasing the risk of bacterial growth.
  • Urinary Stasis: Slowed urinary flow due to the pressure of the uterus can contribute to bacterial growth in the urinary tract.
  • Immune System Changes: Pregnancy can weaken the immune system, making pregnant women more vulnerable to infections, including UTIs.


Symptoms:

  • Frequent urination
  • Pain or burning sensation during urination
  • Cloudy or strong-smelling urine
  • Pelvic pain or pressure
  • Fever or chills (if the infection has progressed)
Pathophysiology of Urinary Tract Infections in Pregnancy

Acute

The bacteria get into the renal pelvis and inflammation. This inflammation causes swelling in the area, starting from the papilla and spread across the cortex. Infection occurs after the occurrence of cystitis, prostatitis (ascending) or due to streptococcal infection from blood (descending). Acute pyelonephritis is usually short and frequent recurrent infections due to incomplete treatment or a new infection. 20 % of recurrent infections occurred after two weeks after completion of therapy.

Bacterial infections of the lower urinary tract in the direction of the kidneys, it will affect kidney function. Upper urinary tract infections associated with bacteria in the urine antibody blanket. Usually enlarged kidneys with interstitial infiltration of inflammatory cells. Abscesses can be found in the kidney capsule and the link kortikomedularis. In the end, atrophy and tubular and glomerular damage occurs.


Chronic

Chronic pyelonephritis is also derived from the bacteria, but can also be due to other factors such as urinary tract obstruction and reflux of urine. Chronic pyelonephritis can permanently damage the kidney tissue as a result of repeated inflammation and scarring onset and may cause renal failure (kidney failure) chronic. The kidneys also form scar tissue progressive, contract and does not work.

The process of development of chronic kidney failure, kidney infections repetitive after a few years or a life-threatening infection. Acute pyelonephritis is often found in pregnant women, usually beginning with hydro ureter and hydronephrosis due to ureteral obstruction due to an enlarged uterus.
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