Pregnancy is associated with several physiological and biochemical changes in a woman’s body. One such change is cloudy urine when pregnant, which might occur for several reasons. In addition, changes in the consistency of urine might also be observed during this time. Some common reasons include bacterial or fungal infection, dehydration, or preeclampsia. Read on to know about the causes of cloudy urine when pregnant, factors that influence it, and treatment management for underlying causes.
Causes Of Cloudy Urine During Pregnancy
The presence of substances such as white blood cells, proteins, or vaginal secretions mixed with urine may impart a cloudy appearance to it. Changes in concentrations of hormones in the urine or even some foods you eat may cause cloudy urine during pregnancy. Other conditions responsible may include the following.
1. Dehydration
The body’s water requirements increase during pregnancy. Water is also lost due to morning sickness, which usually continues up to the 14th week of pregnancy. Dehydration or inadequate fluid intake could concentrate your urine, making it darker in color, cloudy, or denser.
2. Preeclampsia
It is a condition characterized by increased blood pressure and proteinuria (protein in urine), which could be accompanied by kidney and liver problems in a pregnant woman. Other symptoms include swelling in the hands and feet, headache, nausea, or problems with vision. It may have serious consequences such as convulsions and kidney or liver failure in the mother and cause preterm birth. Preeclampsia generally occurs in the second trimester (after 20 weeks) and may cause cloudy urine due to the proteins present in it or due to poor kidney function (1).
3. Kidney stones
Stones may be formed in kidneys (nephrolithiasis) or other parts of the renal system such as ureters or urethra (urolithiasis). They are composed mainly of calcium oxalate or phosphate and less commonly of uric acid, struvite, and cystine. Stones are quite rare during pregnancy but may cause complications. Besides flank pain and difficulty in urination, hematuria (blood cells in urine) may occur, causing the urine to turn cloudy (2).
4. Urinary tract infection (UTI)
The growing fetus exerts pressure on the adjacent urinary bladder, decreasing its capacity and causing a pregnant woman to urinate frequently. Additionally, hormonal changes (progesterone relaxes smooth muscles) cause physiological changes in the urinary tract, making it prone to urinary tract infection(UTI). UTIs are mostly bacterial infections that start from the urinary tract and, if left untreated, may reach up to the kidneys. Cloudy urine with a strong smell or a tinge of blood may indicate UTI. Additionally, fever, chills, flank pain, and nausea may occur (3) (4).
5. Fungal infections
The acidic environment of the vagina changes during pregnancy, increasing the risk of yeast overgrowth. Increased vaginal discharge is common during pregnancy, but a fungal (yeast) infection may cause excess cottage cheese-like discharge with foul smell, vaginal itching, or painful urination. Urine may become cloudy if it mixes with the vaginal discharge (5).
6. Sexually transmitted diseases (STDs)
Sexually active pregnant women may also contract STDs such as chlamydia, gonorrhea, and syphilis. Untreated STDs could increase the risk of preterm birth and many health issues in the newborn. STDs may not cause symptoms initially, but you should look out for excess vaginal discharge, abdominal or pelvic pain, and painful urination. Urine analysis may show pyuria or the presence of white blood cells in urine (produced when the body fights infection), giving urine a cloudy appearance (6).
Diagnosis Of Reasons That Cause Cloudy Urine
Preliminary diagnosis depends on the symptoms accompanying cloudy urine in pregnant women. Inform your gynecologist about any unusual signs and symptoms suggestive of an underlying condition. It may be further diagnosed through the following procedures.
Urine analysis refers to testing a sample of your urine for the presence of substances that would help in identifying the underlying condition. For example, UTI and certain STIs are detected based on the type of bacteria found in urine cultures. The presence of protein may indicate preeclampsia if the woman is already hypertensive (1). The American College of Obstetrics and Gynecology recommends a urine culture at your first prenatal visit and a re-analysis during the third trimester to rule out harmful infections (7).
Blood tests to determine liver and kidney functions or screen for infections.
Imaging techniques such as an ultrasound or magnetic resonance urography are performed to detect kidney stones (2).
Treatment For Cloudy Urine During Pregnancy
The treatment will depend on the underlying cause. The condition may resolve with some home remedies, or your doctor may suggest specific treatment depending on the diagnosis.
1. Stay hydrated
Proper hydration with ample water intake may solve the issue. However, you may need intravenous fluids if dehydration is severe or the water intake is impossible.
2. Get rest and frequent follow-ups
You are advised to rest and reduce salt intake for mild cases, but your doctor may increase the frequency of prenatal check-ups. Severe preeclampsia may require treatment with antihypertensive and anticonvulsant (anti-seizure) medications (8).
3. Include prescribed medications
Management depends on the size and location of the stones. Most of the small ones pass spontaneously in a few weeks. Your physician may advise you to increase water intake and prescribe pain medications. Make sure you do not take OTC pain killers without consulting your doctor. The need for invasive treatment depends on the stage of pregnancy and complications that may arise due to larger stone size, infection, or severe pain (2).
4. Try home remedies
Mild infections may be treated with home remedies such as (9):
Drinking more water to flush bacteria
Cranberry as juice or in salads prevents bacteria from sticking to the walls of the urinary tract
Probiotics such as yogurt that contains beneficial bacteria (lactobacillus) that restricts the growth of harmful bacteria
Antibiotics may be prescribed in case of persistent or severe infection.
5. Prefer topical medication for fungal infections
Topical antifungal creams or suppositories applied inside the vagina are preferred during pregnancy as most oral antifungal medications are contraindicated. Consult your gynecologist before using any OTC medication (5).
6. Get an accurate diagnosis for STDs
STDs need to be accurately diagnosed, and only prescribed antibiotics should be used for treatment.
