Medical Malpractice
During pregnancy, a woman is at higher risk of certain infections because her body changes as the baby develops. Hormonal changes during pregnancy can dilate the ureters, while the growing uterus can put pressure on the urinary tract. These changes can slow urine flow and make it easier for bacteria to collect and spread.
Urinary tract infections (UTIs) are among the most common infections during pregnancy, and many pregnant women experience recurrent infections throughout gestation. UTIs are usually not a cause for concern as they can be treated successfully with standard antibiotics, but expecting mothers should be cautious about the potential risks involved as an untreated UTI can spread to other areas of the body and cause complications for the baby.
The key to managing a UTI is a careful initial assessment, along with ongoing assessments of the woman’s urinary status, which are essential parts of quality prenatal care.
If your baby was injured because of a failure to diagnose and treat a UTI, you may be entitled to financial compensation. Our birth injury lawyers at Miller & Zois can help investigate your case and determine if you have a valid claim. Call us at 800-553-8082 or contact us online.
What Is a Urinary Tract Infection?
A UTI is a bacterial infection that affects the urinary tract and bladder. Bacteria collect inside the woman’s urethra and can spread to the bladder, causing uncomfortable symptoms. Anyone can get a UTI, but women are more likely to get one due to their urethra being much shorter. A short urethra makes it easier for bacteria to reach the bladder. Pregnant women are at an even higher risk of getting UTIs because of the hormonal changes occurring in the body and the physical development of the baby.
A UTI might not seem like a big deal at first, especially if you have had one before and know the drill. But during pregnancy, it is different. What starts as mild discomfort can escalate quickly, and the stakes are higher when a baby is involved. Sometimes, women downplay their symptoms or put off calling the doctor because they think it will go away on its own. That delay can make things worse. It is better to be overly cautious now than to regret not acting later. If something feels off, trust your gut and get it checked.
Hormones trigger the woman’s body to start ureteral dilation, a process in which the ureters expand during pregnancy. An enlarged urinary tract can allow more bacteria to collect inside it, which increases the risk of infection. As the fetus grows inside the mother, it begins to put pressure on the urinary tract as well. This can contribute to urinary stasis and make it more difficult for the bladder to empty completely.
What Are the Symptoms of a UTI for a Pregnant Woman?
Several symptoms could indicate you have a UTI. A woman may experience one or multiple symptoms depending on how far along the infection is. Some women aren’t immediately aware they have an infection, which is one reason urine culture screening early in pregnancy is important. Symptoms of a UTI include:
- Burning or painful urination
- Cloudy or bloody urine
- Foul-smelling urine
- Frequent urination
- Constantly feeling like you have to urinate
- Pelvic or lower back pain
- Fever
- Nausea or vomiting
If you’ve had a UTI before, it can be easy to quickly identify the symptoms. Women who have had prior infections may be more prone to getting them during pregnancy. Pregnant women who start exhibiting signs of a UTI should contact their healthcare provider and get tested as soon as possible.
Asymptomatic Bacteriuria During Pregnancy
One of the reasons urinary infections during pregnancy are different is that a woman can have significant bacteria in her urine without having any UTI symptoms at all. This is called asymptomatic bacteriuria.
Current obstetrical guidelines recommend screening pregnant women for asymptomatic bacteriuria with a urine culture once early in prenatal care. If that first culture is negative, there is not enough evidence to recommend routine repeat screening throughout the pregnancy.
This matters in a malpractice case. A woman does not necessarily have to complain of burning, urgency, or pain for there to be an infection that requires treatment. Sometimes the issue is whether the prenatal provider ordered the appropriate urine culture, saw the result, and acted on it.
Diagnosis and Treatment
Diagnosing a UTI is relatively simple. When you see the doctor, they will usually ask you to provide a urine sample. A urinalysis can look for evidence that suggests infection, and a urine culture can identify the bacteria causing it.
For a pregnant woman with symptoms of acute cystitis, a urine culture is particularly important because it can confirm the infection and help determine which antibiotics will work against the bacteria.
The first-line treatment for a UTI is usually a course of antibiotics. Doctors will make sure to prescribe an antibiotic that is appropriate during pregnancy and that is likely to be effective against the bacteria causing the infection.
Current guidance generally recommends a 5- to 7-day course of antibiotics for acute cystitis during pregnancy. If treatment is started before the urine culture and sensitivity results come back, the antibiotic may need to be changed once doctors know exactly what bacteria they are dealing with and which drugs will kill it.
This is one place where older treatment advice has changed. Because E. coli resistance to amoxicillin and ampicillin is high in many areas, these drugs generally should not be selected for empiric treatment before culture results are available.
How Does a UTI Affect My Baby?
A minor UTI that is localized in the urethra and bladder will most likely not cause any harm to your baby. However, if a UTI is left untreated, the infection can spread up through the ureters and into your kidneys, leading to a kidney infection. A kidney infection is much more serious than a UTI and can cause pregnancy complications.
The big concern is that a urinary tract infection can cause contractions that, if not stopped, can lead to preterm labor. Babies delivered prematurely are subject to much greater risk than a baby delivered at or closer to the baby’s due date.
Kidney infections, also referred to as acute pyelonephritis, are associated with preterm labor and low birth weight. Delivering a child before their due date and having a low birth weight can put the child at a high risk of contracting illnesses and other health conditions. In severe cases, the infection can spread into the bloodstream, resulting in sepsis. Sepsis requires emergency treatment and can lead to devastating complications for both mother and baby. Symptoms of a kidney infection include high fever, chills, and vomiting, along with regular UTI symptoms.
When a UTI Becomes a Kidney Infection
A kidney infection, or pyelonephritis, is the most serious type of urinary tract infection during pregnancy. The infection usually develops when bacteria travel upward from the bladder into the kidneys.
Doctors should suspect pyelonephritis when a pregnant woman has a fever of 100.4°F or higher and urine testing suggesting a UTI, particularly when she also has flank pain or tenderness over the kidney area. Nausea, vomiting, chills, and other signs of systemic illness may also be present.
Not every patient walks in with every symptom checked off neatly. A pregnant woman may have only some of these findings while the infection is developing. That is why the whole clinical picture matters.
Pyelonephritis can cause preterm contractions or labor, sepsis, septic shock, kidney problems, and acute respiratory distress syndrome. Current obstetrical guidance recommends initially treating pyelonephritis during pregnancy in the hospital.
Antibiotics should be started without waiting for final culture results and then adjusted if necessary when the urine culture and sensitivity results come back. The patient generally receives IV antibiotics until she is clinically improving and completes a total of 14 days of antibiotic treatment.
How Can You Prevent a UTI When You Are Pregnant?
The good news about UTIs is that there are several things that may help reduce the risk of infection or urinary irritation. If you are dealing with recurrent UTIs, it may be beneficial to discuss preventive measures with your doctor. It’s important to know that some pregnant women will get UTIs regardless of taking preventive measures because of the way pregnancy affects their bodies.
Some commonly recommended measures include:
- Using the bathroom frequently, especially before and after sex
- Wearing cotton underwear
- Avoiding douches, perfumes, or sprays
- Staying hydrated by drinking water throughout the day
- Using fragrance-free and gentle soaps around the genital area
- Wiping from front to back when using the bathroom
If you get a UTI during pregnancy, try not to get too worried. A UTI is highly treatable, and most infections are treated without long-term complications for you or your baby. Still, you really want to meet with your doctor as soon as you start experiencing symptoms.
If your UTI is not improving after treatment, your doctor may need to look at the urine culture again, determine whether the bacteria are resistant to the antibiotic, change the medication, or consider whether the infection has spread to the kidneys. UTIs are common during pregnancy, and multiple infections do not always mean something is wrong with your body.
Recurrent UTIs During Pregnancy
For many pregnant women, a UTI is a one-time problem. Others have recurrent infections during the same pregnancy.
There is not one treatment rule for every woman who has another UTI. But after a recurrent infection, a doctor may consider suppressive antibiotic treatment for the remainder of the pregnancy. If that is done, the antibiotic should generally be one that the bacteria has already shown itself to be susceptible to.
This is another reason the urine culture matters. Treating an infection is not just about prescribing an antibiotic. It is about prescribing an antibiotic that actually works against the organism causing the infection.
When a UTI Becomes a Medical Malpractice Issue
Most UTIs during pregnancy can be treated without any long-term harm to the mother or baby. But when a doctor fails to diagnose the infection, delays treatment, or prescribes medication that does not effectively treat the infection, the consequences can be serious. If an untreated UTI turns into a kidney infection, it can lead to preterm labor, low birth weight, or even life-threatening complications like sepsis.
Doctors and other healthcare providers have a duty to appropriately monitor for signs of infection during pregnancy. That includes obtaining the recommended urine culture early in prenatal care, promptly reviewing lab results, evaluating UTI symptoms when reported, and prescribing safe, effective antibiotics when necessary. If your doctor failed to diagnose a UTI or ignored symptoms you reported, and your baby suffered a birth injury as a result, that may very well be actionable medical malpractice.
There are a number of ways these cases can develop. A provider may fail to act on a positive urine culture. A pregnant woman may repeatedly complain of UTI symptoms without receiving appropriate testing. A provider may prescribe an antibiotic and never change it, even after the culture shows the bacteria are resistant. Or doctors may fail to recognize that what began as a bladder infection has progressed to pyelonephritis.
You do not just need to prove that the infection happened. You also need to show that your provider did not follow the standard of care expected during pregnancy. If a reasonably careful doctor would have caught and treated the infection in time, and the failure to do so caused harm, that is a foundation for a strong case for medical negligence.
You have to remember, too, that malpractice is not always enough to win a medical mistake case. Even if a doctor made a mistake, we still need to prove that the mistake probably caused the injury. In a serious UTI malpractice case, that means showing that timely diagnosis and appropriate antibiotics probably would have prevented pyelonephritis, maternal sepsis, premature delivery, or the baby’s resulting injuries.
Contact a Birth Injury Lawyer About UTIs and Infections
If your baby was born with a birth injury that may have been related to a failure to diagnose and treat a UTI or other type of infection during pregnancy, you may be entitled to financial compensation. The birth injury lawyers at Miller & Zois can help investigate your case and determine if you have a valid claim. Call us at 800-553-8082 or contact us online.