Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-27T17:04:32.264Z Has data issue: false hasContentIssue false

Chapter 7 - Urinary Tract Problems in Pregnancy

Published online by Cambridge University Press:  14 July 2023

By
Neil Harvey ,
Ian Pearce  and
Rohna Kearney
Edited by
Swati Jha  and
Priya Madhuvrata
Swati Jha
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Priya Madhuvrata
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Get access

Summary

Lower urinary tract symptoms occur commonly during pregnancy with two thirds of women reporting urinary frequency and nocturia. Stress urinary incontinence is reported by 50% of pregnant women and women who experience stress urinary incontinence during pregnancy are more likely to have persistent stress urinary incontinence post-partum. Pelvic floor muscle training is advised for women from 20 weeks of pregnancy who have a first degree relative with pelvic floor dysfunction. For women who fall pregnant following a continence procedure, delivery by Caesarean section is usually recommended. Urinary retention during pregnancy can be acute or chronic and catheterisation is the mainstay of treatment. Care needs to be taken with bladder management in women who have had spinal anaesthesia or following instrumental delivery or perineal trauma. Pregnancy in women following previous urinary tract reconstruction, renal transplantation or with congenital urological anomalies requires multidisciplinary involvement.

Keywords

pregnancyurinary tracturinary incontinenceurinary retentionrenal transplanturinary reconstruction
Type
Chapter
Information
Gynaecology for the Obstetrician , pp. 61 - 71
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rajavuori, A., Repo, J. P., Häkkinen, A., et al. Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 8 (2021), 100138. PMC8605044.Google Scholar
Lin, K. L., Shen, C. J., Wu, M. P., et al. Comparison of low urinary tract symptoms during pregnancy between primiparous and multiparous women. BioMed Research International, (2014), 303697.Google Scholar
Patel, K., Long, J. B., Boyd, S. S. and Kjerulff, K. H.. Natural history of urinary incontinence from first childbirth to 30-months postpartum. Archives of Gynecology and Obstetrics, 30 (2021), 713–24.Google Scholar
Giugale, L. E., Moalli, P. A., Canavan, T. P., Meyn, L. A. and Oliphant, S. S.. Prevalence and predictors of urinary incontinence at 1 year postpartum. Female Pelvic Medicine and Reconstructive Surgery, 27 (2021), e436–e441.CrossRefGoogle ScholarPubMed
Haylen, B. T., Ridder, D. de, Freeman, R. M., et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics, 29 (2010), 4–20.CrossRefGoogle ScholarPubMed
Woodley, S. J., Lawrenson, P., Boyle, R., et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, (2020), Art. No.: CD007471.Google Scholar
National Institute for Health and Care Excellence. NICE Guideline NG210: Pelvic Floor Dysfunction: Prevention and Non-Surgical Management. (2021). www.nice.org.uk/guidance/ng210/resources/pelvic-floor-dysfunction-prevention-and-nonsurgical-management-pdf-66143768482501Google Scholar
Pradhan, A., Tincello, D. G. and Kearney, R.. Childbirth after pelvic floor surgery: Analysis of Hospital Episode Statistics in England, 2002–2008. British Journal of Obstetrics and Gynaecology, 120 (2013), 200–4.Google Scholar
Tulokas, S. A., Rahkola-Soisalo, P., Gissler, M., Mikkola, T. S. and Mentula, M. J.. Pregnancy and delivery after mid-urethral sling operation. International Urogynecology Journal, 32 (2021), 179–86.Google Scholar
Shah, J. P. and Dasgupta, P.. Voiding difficulties and retention. In Stanton, S. L. and Monga, A. K. eds., Clinical Urogynaecology. (London: Churchill Livingstone, 2000), pp. 259–72.Google Scholar
Panicker, J. N., Anding, R., Arlandis, S., et al. Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI‐RS 2017. Neurourology and Urodynamics, 37 (2018), S75–S85.CrossRefGoogle ScholarPubMed
Yip, S., Sahota, D., Pang, M., et al. Postpartum urinary retention. Acta Obstetricia et Gynecologica Scandinavica, 83 (2004), 881–91.Google Scholar
Rantell, A., Veit‐Rubin, N., Giarenis, I., et al. Recommendations and future research initiative to optimize bladder management in pregnancy and childbirth International Consultation on Incontinence – Research society 2018. Neurourology and Urodynamics, 38 (2019), S104–S110.CrossRefGoogle ScholarPubMed
Institute of Obstetricians and Gynaecologists (Royal College of Physicians of Ireland) and the Directorate of Clinical Strategy and Programmes (Health Service Executive of Ireland). Clinical Practice Guideline: Urinary Retention: Management of Urinary Retention in Pregnancy, Post-Partum and After Gynaecological Surgery. (2018). https://rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/12/UR-guidelines-for-clinical-care-pathway-17.05.18.pdfGoogle Scholar
National Institute for Health and Care Excellence. Clinical Guideline CG190: Intrapartum Care for Healthy Women and Babies. (2017). www.nice.org.uk/guidance/cg190/resources/intrapartum-care-for-healthy-women-and-babies-pdf-35109866447557Google Scholar
National Institute for Health and Care Excellence. NICE Guideline NG192: Caesarean Birth. (2021). www.nice.org.uk/guidance/ng192/resources/caesarean-birth-pdf-66142078788805Google Scholar
Abrams, P., Cardozo, L., Fall, M., et al. The standardisation of terminology of lower urinary tract function: Report from the standardisation sub‐committee of the International Continence Society. Neurourology and Urodynamics, 21 (2002), 167–78.CrossRefGoogle ScholarPubMed
Biers, S. M., Harding, C., Belal, M., et al. British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction. BJU International, 129 (2022), 151–9.CrossRefGoogle ScholarPubMed
Thomas, J. C., Squiers, A. N. and Kaufman, M. R.. Sexual function and pregnancy in the female myelodysplasia patient. In Wood, H. M. and Wood, D., eds., Transition and Lifelong Care in Congenital Urology. (Switzerland: Springer International Publishing, 2015), pp. 45–54.CrossRefGoogle Scholar
Shah, S., Venkatesan, R. L., Gupta, A., et al. Pregnancy outcomes in women with kidney transplant: Metanalysis and systematic review. BMC Nephrology, 20 (2019), 24.Google Scholar
Coscia, L. A., Constantinescu, S., Moritz, M. J., et al. Report from the National Transplantation Pregnancy Registry (NTPR): Outcomes of pregnancy after transplantation. Clinical Transplantation, (2010), 65–85.Google Scholar
Bramham, K., Nelson-Piercy, C., Gao, H., et al. Pregnancy in renal transplant recipients: A UK national cohort study. Clinical Journal of the American Society of Nephrology, 8 (2013), 290–8.Google Scholar
Shah, S. and Verma, P.. Overview of pregnancy in renal transplant patients. International Journal of Nephrology, (2016), 4539342.Google Scholar
Sibanda, N., Briggs, J. D., Davison, J. M., et al. Pregnancy after organ transplantation: A report from the UK transplant pregnancy registry. Transplantation, 83 (2007), 1301–7.Google Scholar
Davison, J. M.. The effect of pregnancy on kidney function in renal allograft recipients. Kidney International, 27 (1985), 74–9.CrossRefGoogle ScholarPubMed
Betran, A. P., Ye, J., Moller, A-B., et al. Trends and projections of Caesarean section rates: Global and regional estimates. BMJ Global Health, 6 (2021), e005671.Google Scholar
Gordon, C. E. and Tatsis, V.. Shearing-force injury of a kidney transplant graft during Cesarean section: A case report and review of the literature. BMC Nephrology, 20 (2019), 94.CrossRefGoogle ScholarPubMed
Coscia, L. A., Constantinescu, S., Davison, J. M., et al. Immunosuppressive drugs and fetal outcome. Best Practice Research: Clinical Obstetrics & Gynaecology, 28 (2014), 1174–87.Google Scholar
Constantinescu, S., Pai, A., Coscia, L. A., et al. Breast-feeding after transplantation. Best Practice Research: Clinical Obstetrics & Gynaecology, 28 (2014), 1163–73.Google Scholar
Greenwell, T. J., Venn, S. N., Creighton, S., et al. Pregnancy after lower urinary tract reconstruction for congenital abnormalities. BJU International, 92 (2003), 773–7.Google Scholar
Rintala, R. J.. Congenital cloaca: Long-term follow-up results with emphasis on outcomes beyond childhood. Seminars in Pediatric Surgery, 25 (2016), 112–16.Google Scholar
Deans, R., Banks, F., Liao, L-M., et al. Reproductive outcomes in women with classic bladder exstrophy: An observational cross-sectional study. American Journal of Obstetrics and Gynecology, 206 (2012), e1–6.Google Scholar
Giron, A. M., Passerotti, C. C., Nguyen, H., et al. Bladder exstrophy: Reconstructed female patients achieving normal pregnancy and delivering normal babies. International Brazilian Journal of Urology, 37 (2011), 605–10.Google Scholar
Jungers, P.. Reflux nephropathy and pregnancy. Baillière’s Clinical Obstetrics and Gynaecology, 8 (1994), 425–42.Google Scholar
Hollowell, J. G.. Outcome of pregnancy in women with a history of vesico‐ureteric reflux. BJU International, 102 (2008), 780–4.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×