Cystitis in early pregnancy: signs, consequences

It has long been no secret that the beautiful half of humanity, due to its physiological characteristics, suffers from inflammation of the bladder much more often than the strong one. And it is precisely in the happiest period for a woman - pregnancy, that the risk of getting this pathology increases many times over.

It is in the early period of gestation that this pathology occurs especially often, sometimes even before the woman has learned about her "interesting" situation. In addition, cystitis is considered a non-specific or conditional sign of the onset of the gestational period.

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Epidemiology

Statistics show that every tenth woman in the first trimester of pregnancy suffers from this pathology, if we do not take into account latent and sluggish forms.

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Causes early pregnancy cystitis

Due to hormonal changes in the body of a pregnant woman, immunity is significantly reduced. This is the main reason for the occurrence of bladder inflammation.

The factors that cause this pathology are divided depending on their nature: infectious or non-infectious. For example:

1. Infectious inflammation of the bladder:
   • conditionally pathogenic microorganisms (Streptococcus, Escherichia coli, Staphylococcus);
   • very risky for this period pathogens of venereal pathologies (Mycoplasma, Ureaplasma parvum, Trichomonas vaginalis);
2. Non-infectious inflammation of the bladder:
   • stress;
   • exhaustion;
   • hypothermia;
   • vaginal dysbacteriosis;
   • use of medications over a long period of time;
   • violation of the integrity of the walls of the bladder.

Due to the fact that during gestation the protective function of the immune system is greatly reduced in pregnant women, inflammation of the bladder is mainly infectious in nature. In addition, if a woman suffered from this pathology from time to time before pregnancy, the likelihood of its recurrence increases significantly.

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Risk factors

Risk factors for the development of cystitis during early pregnancy may include:

• reduced immunity;
• restructuring of hormonal levels;
• violation of vaginal microflora;
• the presence in the patient's medical history of a mention of a predisposition to this pathology.

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Pathogenesis

In the first weeks of pregnancy, from the moment of hypothermia or another influencing factor until the appearance of the first symptoms, very little time passes, and the disease itself always begins acutely.

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Symptoms early pregnancy cystitis

Inflammation of the bladder in early pregnancy can occur in two forms:

1. Acute:
   • Frequent urination with pain;
   • Pain in the lower abdomen (from a nagging pain with slight soreness at the end of urination to a sharp pain with the inability to hold urine);
   • Presence of blood in the urine;
   • Increased body temperature.
2. Chronic:
   • The same symptoms as in the acute form, but more pronounced.

Complications and consequences

Bladder inflammation is not as harmless as it may seem at first glance. In women during gestation, due to physiological conditions, inflammation is very dangerous, as it can cause many complications.

The biggest complication may be the spread of infection further along the urinary tract and the development of gestational pyelonephritis. This, in turn, may lead to the following complications:

• Termination of pregnancy;
• Infection of the fetus in the womb;
• Infectious-toxic shock condition;
• Acute renal failure;
• Abscess formation;
• Paranephritis;
• Fetoplacental insufficiency.

That is why it is so important to seek medical help at the first signs of bladder inflammation. Cystitis does not affect the conception of a child, but it greatly complicates the course of pregnancy.

Is it risky to develop bladder inflammation in early gestational period?

If a woman does not self-medicate and consults a doctor at the initial symptoms of bladder inflammation, then the likelihood of a positive treatment result without consequences for her and the child increases significantly.

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Diagnostics early pregnancy cystitis

The diagnosis of this pathological process goes through the following stages:

• Patient complaints;
• General urine test – it shows: urine density, presence of protein or microorganisms, number of leukocytes and erythrocytes.
• General blood test – it can show signs of inflammation, increased levels of leukocytes and erythrocyte sedimentation rate. Most often, there will be no clear changes in the blood. If they are clearly expressed, this will indicate a strong inflammatory process and probable exacerbations;
• Examination by an obstetrician-gynecologist;
• Ultrasound examination (in particular cervicometry) – to differentiate from termination of pregnancy;
• Urologist examination – it is he who evaluates the test results and prescribes treatment. Gynecologist – monitors the treatment process. A repeated urologist examination may be necessary in case of low efficiency or relapse of the pathology.
• Urine test according to Nechiporenko. The content of leukocytes, erythrocytes and cylinders in urine is assessed.
• Urine tests according to Zimnitsky. The density of urine is determined at different times of the day, the predominance of urine volume in the morning or evening.
• Presence of protein in urine per day. A decrease in protein in urine per day is determined.
• Urine culture for microflora and resistance to drugs with antibacterial activity.

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Treatment early pregnancy cystitis

The main thing in this period is not to self-medicate. The attending physician will prescribe the most gentle treatment, so the main thing in the early stages of gestation is not to harm the health of the child. Therefore, strong drugs, such as Monural, are unlikely to be prescribed.

The treatment will consist of several stages:

1. Anti-inflammatory therapy:

The doctor may prescribe medications in the form of either pills or injections.

For example, during this period you can use: Ibuclin, Diclofenac, Paracetamol, Ibuprofen.

Should not be used due to the risk of miscarriage or abnormalities in the child: Meloxicam, Celecoxib.

2. Antifungal therapy:

Antifungal drugs can only be prescribed by the attending physician, having previously assessed the probable risks for the child with the benefit for the mother. The medication is prescribed only if the analysis has shown the presence of pathogenic microflora. They must be taken orally.

3. Instillation:

Since the use of antibacterial drugs is not possible in the early stages of the gestation period, the attending physician may prescribe a bladder instillation. The procedure involves infusing an antibiotic solution into the bladder through the urethral canal. This provides a local antibacterial effect without any effect on the fetus.

Drug therapy

To treat bladder inflammation, you can use the following regimens:

1. Fosfomycin trometamol three grams, powder, one-time orally;
2. Cefixime - four hundred milligrams 1 time/day, week;
3. Ceftibuten four hundred milligrams 1 time/day, week;
4. Cefuroxime 250-500 mg (pills, orally 2 times a day for a week;
5. Amoxicillin/clavulanate, pills, capsules - 500/125 mg 3 times a day for a week.

A couple of days after the start of treatment with one of the regimens, a mandatory bacteriological test of urine must be performed.

If pathogens are not identified, therapy can be stopped.

If the pathogen is detected during repeated tests, the treatment regimen should be started again, even if there are no clinical manifestations.

Then, every month, until the onset of labor, the patient must submit urine for bacterial culture, even if the pathogen is not detected.

In the case where the uropathogen is detected again after the second course of treatment, microbial suppressive therapy should be periodically administered until the onset of labor.

However, it is worth noting that many doctors consider such therapy to be toxic, and it is extremely undesirable in the gestation period. Therefore, they recommend using antimicrobial therapy only during periods of exacerbation of chronic inflammation of the bladder.

The main problematic factors that appear during inflammation therapy:

1. The presence of concomitant pathology in the form of vaginal dysbiosis;
2. Increasing levels of antibiotic resistance;
3. High risk of relapse and transition of the pathology into a chronic form;
4. Long time to perform urine culture;
5. Rapid clinical picture of pathology;
6. Women's tendency to self-medicate, which significantly complicates diagnosis.

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Folk remedies

In addition to the main treatment during this period, after consultation with a doctor, as an additional treatment, you can use folk remedies. But it is worth remembering that by self-medication, a woman risks aggravating the pathology process and prolonging the therapy period. In folk treatment, the following schemes are used to treat this pathological process:

1. Crushed asparagus roots (twenty grams) should be covered with a glass of water and infused. Drink four times a day, half a glass.
2. Oat grains (a glass) should be poured with two glasses of boiling water. Then put in a water bath and boil until the water is reduced by half. Then add two tablespoons of honey and boil again for about five to ten minutes. Drink half a glass three times a day.
3. Pour a glass of boiling water over two glasses of field needles and let it brew. Drink fifty to seventy milliliters of this infusion four times a day.
4. The herb of flowering mint (twenty grams) should be poured with 1.5 liters of hot water and boiled for five to ten minutes. Then everything should be cooled. Drink one glass three times a day.
5. Red rowan berries and lingonberry leaves should be mixed in a ratio of three to one. One tablespoon of the mixture should be covered with a glass of boiling water and infused for three to four hours. Then the infusion should be filtered. Take half a glass for half an hour before eating three to four times a day, add a teaspoon of honey to the infusion.

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Herbal treatment

Phytotherapy can be used during gestation as an auxiliary means. Indications for it are:

• Active phase of the inflammatory process (only in combination with antibacterial therapy);
• To increase the duration of the effect, after the treatment;
• During the period of remission;
• For prophylaxis, in order to prevent recurrence of urinary infection in women during gestation who have a burdened medical history.

The following can be used as a phytotherapy:

1. Canephron N is a herbal medicine that is used two pills three times a day with a large volume of water. The duration of therapeutic treatment is two weeks. It is used in combination with other medicines and as a medicine during recovery.
2. Brusniver is a collection of plants that is used internally in the form of a freshly brewed decoction or infusion.

To make a decoction you need to: pour one bar of the substance into 0.5 liters of hot water and boil for a quarter of an hour, then leave to infuse for 45 minutes.

The infusion should be prepared a little differently: one plate of the substance should be poured with 0.5 liters of water, which is boiled and infused in a thermos for two hours. It should be taken internally one third of one quarter of a glass 3-4 times a day from one week to one month. Brusniver is also used for combined therapy of the pathological process in the bladder, since it is almost impossible to cope with this infection with one herbal collection.

3. Zhuravit is a herbal preparation based on cranberry extract and ascorbic acid. Zhuravit is presented on the pharmaceutical market in the form of capsules, they should be taken one piece three times a day during the first three days of the pathological process, and then one capsule in the morning. The duration of therapeutic treatment can vary greatly and is subject to the course of the disease.
4. Cystone is a herbal preparation in tablet form. It does not contain any data on the possibility of use during gestation, nor on the impossibility. Therefore, if the patient does not have hypersensitivity to any component of the drug, it can be used during this period. Two pills are used twice a day until the inflammatory process is relieved.

Homeopathy

Of course, many women prefer homeopathic treatment to antibacterial. But in this case, every woman who prefers this method of treatment should know that a positive effect can only be seen if the treatment is carried out by a qualified medical worker.

However, even official medicine, when it comes to treating a woman during gestation, prefers homeopathic treatment.

Homeopathy has shown its high efficiency as an auxiliary means, as an addition to antibacterial therapy. Practice shows that thanks to homeopathy, there is an increase in the effectiveness of treatment, the recovery process occurs faster.

The most commonly used homeopathic medicines are: Canephron and Cyston.

Canephron is a medicine that is practically free of side effects, and also helps to speed up the treatment action well and quickly, without having a negative impact on the child. In addition, it can be used as a preventive measure.

Cystone is a medicinal product characterized by antibacterial activity plus a number of other properties. But despite this, it cannot be used as the main therapy, only as an auxiliary agent.

Prevention

There are several points for preventing the occurrence of an inflammatory process in the bladder. If a pregnant woman follows them, she will significantly reduce the likelihood of this pathological process.

• First. You need to carefully monitor your health and, at the slightest deviation from the norm, immediately seek help from a specialist;
• Second. It is imperative to empty your bladder, and under no circumstances should you hold it in;
• Third. Eliminate any possibility of hypothermia;

Fourth. If the attending physician has not determined any contraindications, it is imperative to drink a sufficient amount of liquid.

In addition to these recommendations, it is also worth engaging in physical activity (to the extent permitted by the attending physician), if the pregnant woman has no contraindications for this.

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Forecast

If a pregnant woman is treated under the supervision of a doctor and the treatment has a positive result, the probability of developing negative consequences will be significantly reduced, and bladder inflammation will no longer bother her during the period of bearing a child. But if this pathology is not treated completely, then the probability of its occurrence again will increase several times.

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