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Two of the most common are urinary tract infections (UTIs) and bacterial vaginosis (BV). When mismanaged, untreated, or misdiagnosed, these infections can lead to permanent birth injuries and other health complications.
A urinary tract infection, or UTI, is an infection in the urinary system. This can include the kidneys, ureter, urethra, and bladder. Pregnant women are at an increased risk for UTIs between weeks 6 and 24. If left untreated, UTIs can cause dangerous, potentially permanent birth injuries, such as brain damage and neonatal infection.
Bacterial vaginosis, or BV, is a bacterial infection of the vagina. It is the result of an imbalance of naturally occurring vaginal flora. Bacterial vaginosis is one of the most common infections in women. About 20% of women will experience this infection during their pregnancy. If bacterial vaginosis is misdiagnosed or mismanaged during a pregnancy, the child can become infected and develop sepsis, experience brain damage, and may even develop conditions such as hypoxic ischemic encephalopathy (HIE) and cerebral palsy.
Changes in Uterine Size: The uterus is situated above the bladder. As such, its growth during pregnancy can prevent drainage of urine from the bladder. This can cause infection.
E. Coli: This bacteria is responsible for 80-85% of UTIs. E. coli can be transmitted from the bowel to the urethra. Once it enters the bladder, E. coli can develop a biofilm resistant to the body’s natural immune response.
Staphylococcus (Staph) Infections: These cause 5-10% of UTI.
Group B Streptococcal (GBS) Infection: This is a specific type of staph infection known to cause about 5% of all UTIs.
Viral and Fungal Infections: Bacteria usually cause UTIs by entering the bladder via the urethra. However, an infection can still occur through the lymph or blood. It’s also important to point out that bacteria can enter the urinary tract during sexual intercourse, as well as via catheters, stool, or even a partial blockage of urinary passages.
Under normal conditions, the vagina contains a diverse flora of microorganisms. The proper bacterial balance actually prevents harmful bacteria from causing health problems. Any change in vaginal bacterial flora can allow harmful, potentially resistant bacteria to dominante. Antibiotic use may wipe out the good bacteria with the bad, making a woman more susceptible to harmful bacterial buildup. The practice of douching is another direct cause of BV.
The most common bladder infection symptoms including burning sensation with urination, frequent need to urinate, and pain. These can range from mild to severe. They typically last about six days in healthy women. Some women may experience pain in the lower back or pubic region. In addition to these symptoms, women with a kidney infection may also experience fever, nausea, and/or vomiting. In some cases, blood may appear in the urine.
The primary sign of BV is abnormal vaginal discharge. Other symptoms may include:
A urine culture can detect UTIs at any point during a woman’s pregnancy. The American College of Obstetrics and Gynecology recommends a urine culture be taken during the first prenatal visit. Repeat cultures should be taken during the third trimester.
The recommendation of the U.S. Preventative Services Task Force is to take a culture between 12 and 16 weeks of gestation. Urine cultures are preferred over office-based screening tests, such as a urinalysis and dipstick testing, as they lack specificity.
To diagnosis BV, the presence of the following are necessary:
The CDC notes that some specialists recommend screening and treatment during the first prenatal visit of women previously had a premature birth. These guidelines also recommend follow up examinations one month after initial screening and treatment.
Throughout the pregnancy, antibiotics can be administered to safely treat UTIs. However, antibiotic courses must be safe to both mother and child.
Ampicillin has historically been the main drug of choice. However, E. coli has recently become increasingly resistant to ampicillin and other antibiotics. These include sulfamethaxazole / trimethoprim (SXT) and ceftriaxone. As such, it is critical that antibiotic susceptibility testing is performed to determine which antibiotics will work to treat a specific infection. In addition, repeat urine cultures must be performed, as UTIs have a high rate of recurrence in pregnant women. Similarly, a doctor must switch to a more sensitive antibiotic if a woman’s infection is not cured with initial treatments, and/or the bacteria in question has become resistant to the antibiotic(s) administered.
In complicated cases, a longer course of oral antibiotics, or the use of intravenous antibiotics may be required. If symptoms fail to improve, further testing will be necessary. Some common antibiotics, such as fluoroquinolones and tetracyclines, should not be used during pregnancy due to the risk of toxic effects on the baby. However, use of these drugs for resistant infections may be deemed appropriate.
Some pregnant women with UTIs present no symptoms of infection. However, since untreated UTIs can cause permanent birth injuries, it vital that doctors detect and treat UTIs in asymptomatic patients. By aggressively screening for and treating pregnant women with asymptomatic UTIs, it is possible to decrease incidence of kidney infection during pregnancy.
Antibiotics, including Metronidazole and/or Clindamycin, can be effective treatments for BV in pregnant women. However, there is a high rate of BV recurrence.
In cases of recurrent BV, Clindamycin therapy typically has better clinical efficacy. One-time doses of Metronidazole are no longer recommended by the CDC due their low efficacy. Intravaginal clindamycin cream must be used in pregnant women only during the first 20 weeks of pregnancy.
A mismanaged UTI can cause dangerous complications. These include:
A mismanaged case of BV can also cause dangerous side complications, such as:
Because of the serious complications associated with UTIs and BV, it is critical that these infections be accurately diagnosed and promptly treated in pregnant women. When this does not happen, and/or when standards of treatment are not followed, it is medical negligence. If this negligence leads to injury to the mother or child, it is medical malpractice.
The following issues may constitute negligence:
If your child experienced a birth injury resulting from mishandling of a UT or BV infection, the team at Willens Law Offices can help.
We have helped the families of children across Illinois get the compensation they need for a secure future. We strive to give the utmost personal attention to each child and family we represent.
Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that speak to our success and experience. You will not pay our firm unless we win or settle your case.
Call Willens Law Offices at (312) 957-4166 for a free case evaluation. Our firm’s expert team are available to you whenever you need them, 24/7.
The plaintiff went to a Chicago hospital for delivery of twins via cesarean section. In the delivery room, a suspicious rash was recognized on one of the twins and later, fecal and urine cultures confirmed the presence of candida. She was started on prophylactic anti-fungal medicine and is healthy. The other twin was clear of any rash and though she was at risk for fungal infection, she was not treated in a timely manner. Later, a head ultrasound and MRI confirmed the diagnosis and damage to her brain. A lawsuit was filed on the plaintiff’s behalf. The case was vigorously defended by lawyers for the physician and the hospital that he worked for over 3 years. Eventually, a mediation took place at which time the defendants offered $3,000,000 to settle, which the plaintiff rejected. It was not until trial that the case settled for $10,000,000.
Birth injury cases are among the most complicated medical malpractice cases to litigate. With years of experience in birth trauma litigation our legal team has the skills, the resources and experience necessary to address and win a wide variety of birth injury cases. Our legal team has secured millions of dollars in compensation for birth injury victims.
With decades of hands-on experience working with top healthcare professionals in labor and delivery, our legal team has access to some of the top medical professionals in the world. As in many types of medical malpractice cases, high quality expert are essential in obtaining justice.
Our firm was established to focus on the unique needs of our clients. We work with top medical, life-planning, and forensics experts to determine the causes and extent of injuries, prognoses of victims, and areas of medical negligence. Our passion for helping birth injury victims allows our attorneys to deliver unrivaled legal services for your family.
Willens Law Offices have helped the families of children across Illinois get the compensation they need for a secure future.
We strive to give the utmost personal attention to each child and family we represent.