North American Registry of Midwives (NARM) Practice Exam

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What physiological change in pregnant women increases their susceptibility to urinary tract infections (UTIs)?

Decreased kidney function
Reduced urine output
Hydronephrosis
Increased hormonal levels

The correct answer is: Hydronephrosis

Hydronephrosis is a condition characterized by the swelling of a kidney due to a build-up of urine. During pregnancy, the growing uterus can exert pressure on the ureters, leading to partial obstruction. This can cause urine to back up into the kidneys, leading to hydronephrosis. As a result, the changes in urine flow and retention can create an environment conducive to bacterial growth, significantly increasing the susceptibility to urinary tract infections (UTIs). This physiological change is particularly relevant in the second and third trimesters when the uterus is larger and exerts more pressure on the urinary tract. As the urinary system becomes more prone to stasis (the slowing or stopping of normal flow), the likelihood of bacteria proliferating and causing infections rises. Understanding this physiological dynamic is crucial for midwives and healthcare providers in monitoring and managing the health of pregnant women.