Elevated white blood cells in urine, combined with painful, frequent, urgent urination, or lower abdominal discomfort, strongly suggest an active urinary tract infection (UTI). Given you are 24 weeks pregnant and experiencing these symptoms, an immediate medical examination is essential. UTIs during pregnancy can pose risks to both mother and fetus if not treated promptly.

Urinary tract infections in pregnancy can range in severity, from asymptomatic bacteriuria to cystitis and, in more severe cases, pyelonephritis. Pregnant women are more susceptible to UTIs due to increased progesterone hormone, which relaxes the ureters and bladder, leading to easier urine retention. The growing uterus also compresses the urinary tract, creating favorable conditions for bacterial growth.

A doctor consults a pregnant woman on health matters. Illustration: Tam Anh Cau Giay General Clinic.

Doctors typically order a complete urinalysis and urine culture to accurately identify the causative bacteria. This helps them select antibiotics safe for pregnancy. Several common antibiotics are used, but they must be prescribed, taken at the correct dosage, and for the full duration.

If not treated promptly, the infection can spread to the kidneys, causing high fever, chills, severe back pain, and increasing the risk of preterm birth and low birth weight. You should go to the hospital immediately if additional symptoms appear, such as: high fever, chills, severe back pain, nausea, vomiting, blood in urine, extreme fatigue, or uterine contractions. These are warning signs of a severe infection or complications, requiring emergency treatment.

Urinary tract infections during pregnancy are prone to recurrence, with a rate of 4-5% within the same pregnancy. To prevent recurrence, pregnant women should follow these effective preventive tips:

- Drink enough water daily, tailored to your body weight and activity level.

- Clean the genital area with a mild solution and pat dry from front to back with a cotton towel.

- Urinate frequently to flush out the bladder.

- Wear loose, comfortable clothing made of breathable, sweat-absorbing materials.

- Cleanse the urethra area thoroughly before and after sexual intercourse.

- Avoid alcohol, spicy foods, and caffeinated beverages.

- Maintain a balanced, healthy lifestyle to boost your body's immunity.

- Undergo urine tests as advised to prevent asymptomatic urinary tract infections.

Dr. Nong Tuyet Phuong

Obstetrics and Gynecology Department

Tam Anh Cau Giay General Clinic