Lower Abdominal Cramps + UTI Would You Be Concerned?

[gummibears]

This is my 4th UTI this pregnancy, or in my entire life. I'm by far not an expert on them, but I do know the signs of trouble that one's here. What I don't know is when one should be worried about the level of pain. This one has been my most painful of all with the tri-pain of pelvic, back and stomach attacking either one at a time or any combo of them at once. It worries me that this one might be more severe. Baby is more active today, which is reassuring as most times on antibiotics she's quiet and that, too is of concern.

Typically I just have pelvic pain which is bad enough, but this one has been worse from the get-go. Today is my second day on meds and I'm having quite a few strong and sharp lower abdominal cramps on my right. I'm sitting still at work, so I'm not aggravating anything by moving oddly, and I know if I were standing up these pains could very well be strong enough to have me doubled over. I'm finding myself having to hold my breath and close my eyes when the pain comes to get through it. Granted they only last a few seconds, but in the time it took to write this I had the cramps 3 more times. Is this normal or is it a sign of concern?

The back pain for now has subsided, but the pelvic pain is as bad as ever. My midwife is out of town for a week, too, so I really don't know what I'd do if there was a reason to go in and get looked at. I'm on Amoxicillian this time, if that helps any.

What would you do?

[KarenMT]

Hi- does your midwife have a backup that you can phone?  Who prescribed the antibiotics?  At this point, I would have two concerns- a) if this is your 4th UTI- are they culturing your urine and looking for signs that you just have a UTI or are they actually going one step further and culturing to the point where they find the specific antibiotic that will work best to counteract your infection?  Amoxicillin is not typically the abx you think of for a UTI- it's pretty mellow.  b) I would call your primary care physician or the on-call midwife about your pains.  It could just be spasms from your UTI, or it might not.  Best to be safe.

[geekgolightly]

Originally Posted by KarenMT 

Hi- does your midwife have a backup that you can phone?  Who prescribed the antibiotics?  At this point, I would have two concerns- a) if this is your 4th UTI- are they culturing your urine and looking for signs that you just have a UTI or are they actually going one step further and culturing to the point where they find the specific antibiotic that will work best to counteract your infection?  Amoxicillin is not typically the abx you think of for a UTI- it's pretty mellow.  b) I would call your primary care physician or the on-call midwife about your pains.  It could just be spasms from your UTI, or it might not.  Best to be safe.

In total agreement. I know you said that your back pain has subsided, but if you have been having back pain, even off and on, I find that to be very disconcerting. Your UTI could have moved into your kidneys, esp as you're only on amoxicillin. Please go ahead and be seen by a physician.

[gummibears]

Originally Posted by KarenMT 

Hi- does your midwife have a backup that you can phone?  Who prescribed the antibiotics?  At this point, I would have two concerns- a) if this is your 4th UTI- are they culturing your urine and looking for signs that you just have a UTI or are they actually going one step further and culturing to the point where they find the specific antibiotic that will work best to counteract your infection?  Amoxicillin is not typically the abx you think of for a UTI- it's pretty mellow.  b) I would call your primary care physician or the on-call midwife about your pains.  It could just be spasms from your UTI, or it might not.  Best to be safe.

She has her office number and an after hours number which is the hospital. She prescribed the antibiotics to me the day I tested postive for the UTI, though I was told it was on the fence if I had one or not (this is after 3-4 days of discomfort)

I'm not sure at all how they are reading the results. I'm not really familiar on what's what just know what they tell me they say afterward.

I decided to hold off on calling and monitor the pains closely. On a hunch I drowned myself in water and found the pains went away, though I wasn't going to the bathroom hardly at all despite the huge increase in water. I determined maybe that indicated dehydration and when the pains went away I deduced that they might have been inter-related.

I did void normally all night long and had no issues with the lower ab pain since. Crossing fingers things are ok. The pelvic pain did get better last night but it's back a bit today.
 

Originally Posted by geekgolightly 

Originally Posted by KarenMT 

Hi- does your midwife have a backup that you can phone?  Who prescribed the antibiotics?  At this point, I would have two concerns- a) if this is your 4th UTI- are they culturing your urine and looking for signs that you just have a UTI or are they actually going one step further and culturing to the point where they find the specific antibiotic that will work best to counteract your infection?  Amoxicillin is not typically the abx you think of for a UTI- it's pretty mellow.  b) I would call your primary care physician or the on-call midwife about your pains.  It could just be spasms from your UTI, or it might not.  Best to be safe.

In total agreement. I know you said that your back pain has subsided, but if you have been having back pain, even off and on, I find that to be very disconcerting. Your UTI could have moved into your kidneys, esp as you're only on amoxicillin. Please go ahead and be seen by a physician.

The back pain and increased pain all around concerned me, but it seems mostly better today. I'm only down to some pelvic pain now. I'm hoping since this is the third day it'll be better as I take my other 2 doses left for today.
 

[KarenMT]

Good luck with this round of antibiotics.  Amoxicillin used to be the standard antibiotic but, like a lot of infections, they are drug resistant to Amox.  If I were preggo and had already done 4 rounds of abx, I would either consult with a urologist or insist that they do a more thorough screening of the bacteria to ensure they are prescribing the correct drug.  After 3 rounds of antibiotics, that may not be the correct match, the only bacteria remaining could be those that are resistant to the first line of antibiotics they gave you and hence these stronger bacteria are multiplying and causing the repeat issues.

[gummibears]

Originally Posted by KarenMT 

Good luck with this round of antibiotics.  Amoxicillin used to be the standard antibiotic but, like a lot of infections, they are drug resistant to Amox.  If I were preggo and had already done 4 rounds of abx, I would either consult with a urologist or insist that they do a more thorough screening of the bacteria to ensure they are prescribing the correct drug.  After 3 rounds of antibiotics, that may not be the correct match, the only bacteria remaining could be those that are resistant to the first line of antibiotics they gave you and hence these stronger bacteria are multiplying and causing the repeat issues.

I'll have to mention this in my next apt. I also had an infection that wasn't a UTI that was "clue cells" that were coated in bacteria. It mimicked the uti and I was stuck taking another antibiotic for THAT. That was about a week or 2 before this last infection came up. I've only been with this midwife for 3 weeks now, so the other screenings were done at the ER here or at my other HCP's office.

I just can't imagine how one person can get so unlucky during one pregnancy and I'm overly concerned of the affect on the baby of so many antibiotics as well. Very scary since I had a round early on for a cyst that was also infected. That was a week before my first uti was found in my first trimester.

[junebug2011]

Hi mama! Sorry you're so uncomfortable!

Everyone is totally right, I rarely see plain-old amoxicillin prescribed for a UTI (I am a triage RN for OB patients, we see at least five UTIs per week). Do you have any allergies to antibiotics? For someone with chronic UTIs, they should definitely be culturing your urine. You do a clean catch (pee, wipe, pee in the cup). They send it off to the lab, culture out the bacteria, then see which antibiotics the bacteria are susceptible to.

This link is a good resource ... they have a table for category B antibiotics to treat UTI during pregnancy (category B is generally considered safe). We typically prescribe Keflex, but then again if the bacteria aren't susceptible, what good is it going to do?

UTIs can give nasty contractions for sure. It's a good gauge for you knowing whether or not the abx is working ... the antibiotic should start giving relief in 24-48 hours and the contractions should definitely go away at that time. 

A complication which some others mentioned is pylonephritis ... that's when the infection climbs up to your kidneys. With this you will feel really, really sick ... fever, shakes, and "flank pain", strong aching pain running down your lower back to your butt.

As you know, drink, drink, drink ... if you are dying you could ask your MW about pyridium until the antibiotics kick in ... category B, stains pee orange but gives a lot of relief. Cranberry pills or unsweetened cranberry juice is great (the juice is acidic and gives me heartburn though). Susun Weed recommends herbal infusions of yarrow and uva ursi (you can ask your MW if she thinks its safe.) Vitamin C (lemon in hot water), oral raw garlic, peppermint are all good immune-boosters. And no sugar!!

Hope this helps! UTIs are awful, I hope you feel better soon.