Pregnancy is responsible for marked changes in the urinary tract and consequently lower urinary tract symptoms are more common and many are simply a reflection of normal physiological change. Urine production increases in pregnancy due to increasing cardiac output and a 25% increase in renal perfusion and glomerular filtration rate.
Frequency of micturition is one of the earliest symptoms of pregnancy affecting approximately 60% in the first- and mid-trimester and 81% in the final trimester. Nocturia is also a common symptom although it was only thought to be a nuisance in 4% of cases. Overall frequency occurs in over 90% of women in pregnancy.
Urgency and urge incontinence have also been shown to increase in pregnancy. Urge incontinence has been shown to have a peak incidence of 19% in multiparous women whilst other authors have reported a rate of urge incontinence of 10% and urgency of 60%. The incidence of detrusor overactivity and low compliance in pregnancy has been reported as 24% and 31%, respectively. The cause of the former may be due to high progesterone levels whilst the latter is probably a consequence of pressure from the gravid uterus.
Stress incontinence has also been reported to be more common in pregnancy, with 28% of women complaining of symptoms although only 12% remained symptomatic following delivery. The long-term prognosis for this group of women remains guarded. Continent women delivered vaginally have been compared to those who had a cae-sarean section. Whilst there was initially a difference in favour of caesarean section this effect was insignificant by three months following delivery .
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.