Urinary Tract Infection(UTI) during Postnatal period

UTI during Postnatal period, this ppt is for nursing staff

1. UTI DURING POSTNATAL PERIOD BY:ANUPAMA KHUMUKCHAM TUTOR,CON AIIMS PATNA

2. Urinary tract infection is defined as an infection of lining of urinary bladder and urethra. A urinary tract infection occurs when an infectious organism enters your urinary tract usually through the urethra and causes an infection. In some case the bacterial infection might travel up to the kidneys resulting in kidney infection. It is one of the common causes of puerperal pyrexia, the incidence being 1-5% of all deliveries

3. What causes UTI post-delivery? A shorter urethra (4 cm) in females as compared to males (20 cm) makes it easy for the bacteria to infect the bladder. Hence UTI is very common in women than in men. And pregnancy makes them more vulnerable. The pelvic floor muscles help in keeping the urethra closed so that urine doesn’t leak out. During labor, theses muscles go into an overdrive along with the ligaments, nerves and muscles of the lower abdomen. Excessive wear and tear during delivery can lead to injury or trauma to this set of muscles and ligaments. They subsequently might fail to do their job as they did pre- labour . Pregnancy may also cause the bladder to lose its tone making it difficult for women to completely empty their bladder. This makes the urine more susceptible to flow back up the ureters. The longer the urine stays in the urinary tract, the higher the chances of bacteria to multiply, and hence, higher the vulnerability to infection. Certain factors that increased risk are cesarean birth, use of forceps and vacuum extraction, epidural anesthesia and catheterization during labor

4. Sign and Symptoms of Cystitis Burning or pain on urination Urgency Frequency Suprapubic tenderness Low grade fever Urinalysis examines the following Leukocytis RBC Bacteria

5. Signs and Symptoms of pyelonephritis Dysuria Urgency Frequency Temperature elevation Chills Flank pain Lower abdominal pain Costovertebral angle tenderness Elevated WBC(20000-30000mm3) Urinalysis similar to those of Cystitis

6. TREATMENT Promote non-pharmacologic measures for comfort and proper nutrition, hydration and rest. Careful monitoring of intake and output to prevent the hypovolemic shock UTI is normally treated with antibiotics. In some severe cases an intravenous drip with antibiotics may be administered. For breastfeeding mother, antibiotics (Amoxicillin or ampicillin; for penicillin allergy or resistant bacteria,cephalexin,sulfamethoxazole-nitrofurantion or sulfamethoxazole-trimethoprim are used that are safe to take during such postnatal period. Antipyretics may be given to help bring down a fever. Pain killers can help relieve pain. If simple measure fails to initiate micturition, an indwelling catheter is to be kept in situ for about 48hours,it helps in regaining the normal bladder tone and sensation of fullness.Following removal of catheter the amount of residual urine found to be more than 100ml then continuous drainage is resumed Appropriate urinary antiseptics should be administered for about 5-7 days

7. PREVENTIVE MEASURES Drink plenty of water to help flush out bacteria from your excretory system Drink cranberry juice. The juice is scientifically proven to treat as well as prevent UTI by preventing disease-causing organisms from sticking to the walls of the urethra. Have plenty of vitamin C rich foods. They make the urine more acidic and help the body to destroy and reduce the number of UTI causing bacteria in the urinary system. Practice good restroom hygiene. Avoid tampons and regularly change sanitary pads Avoid using perfumed products, creams or gels around the genitals as they can greatly increase the susceptibility to UTI. Wear loose clothes to allow the genitals to remain dry and prevent the growth of bacteria. Avoid sex till 6 weeks. Urinate soon after having sexual intercourse to flush out organisms that may have reached the urethra. Also, wash the area with water thoroughly after having intercourse

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