Diagnosis and Treatment of Pyelonephritis During Pregnancy
Main Article Content
Abstract
Urinary tract infections are the most common infections in pregnant women. The most common are
asymptomatic bacteriuria, cystitis and pyelonephritis, the latter presenting as a complication in 1 to 2%
of women. Urolithiasis is also very common, complicating approximately 1 in every 2,000 pregnancies.
These entities usually occur due to physiological changes that occur during pregnancy, such as
enlargement of both kidneys, increased glomerular filtration rate, as well as dilatation of the renal
pelvis and ureters.
It is important to perform imaging studies to establish the diagnosis, being renal ultrasound the first
line option in the pregnant patient with renal colic because it is harmless to the patient and fetus.
Treatment can be conservative with hydration and pain management with analgesics.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Partin, A., Dmochowski, D, Kavoussi, L (2021). Campbell-Walsh-Wein Urology (12th ed.). Elsevier.
II. Cunningham, F. Leveno, K. Hoffman, B. Casey B (2021). Williams Obstetrics (26th ed.). McGrawHill.
III. McAninch, J. Lue, T (2021). General urology (19 e). McGrawHill.
IV. Navarro A, Sison J, Puno R, et al. Reducing the incidence of pregnancy-related urinary tract infection by improving the knowledge and preventive practices of pregnant women. ejog. 21019; 241: 88 - 93.
V. Rindfleisch A, Do H, Goldson T, Forjuoh S. Septic Shock from pyelonephritis in Pregnancy. Clin Med Rev Case Rep. 2020; 7: 1-3.
VI. Saleh P, Noshad H, Mallah F, Ramouz A. Acute pyelonephritis in Pregnancy and the Outcomes in Pregnant Patients. Clin Infect Dis. 2017; 10: 3 - 7.
VII. DeYoung T, Whittington J, Ennen C, Poole A. Pyelonephritis in Pregnancy: Relationship of Fever and Maternal Morbidity. Am J Perinatol Rep. 2019; 9: 366 - 371.
VIII. Fosu K, Quansah E, Dadzie I. Antimicrobial Profile and Asymptomatic Urinary Tract Infections among Pregnant Women Attending Antenatal Clinic in Blogatanga Regional Hospital, Ghana. Microbiology Research Journal International. 2019: 1 - 8.
IX. Hintz L. Diagnosis and Management of Urinary Tract Infections and Pyelonephritis. Springer International. 2017: 169 - 189.
X. Ruxandra P, Gica N, Ciobanu A, Cimpoca B, et al. Urinary Tract infections in pregnancy. Ro J Med Pract. 2021; 16: 40 - 45.
XI. Akyuz O, Akhan O, Ardahanh I, Aslan R. Urinary System and Pregnancy. MCRR Journal. 2020; 3: 317 - 321.
XII. Cox S, Reid F. Urogenynaecological complications in pregnancy: an overview. Obstetrics, gynaecology and reproductive medicine. 2017; 28: 77 - 82.
XIII. Rosana Y, Halim M, Harlinda F, Amran R, et al. Urinary Tract infections among Indonesian Pregnant Women and Its susceptibility Pattern. Infectious Diseases in Obstetrics and Gynecology. 2020; 1 - 7.
XIV. Gokcen O, Esra U, Banu S, et al. Maternal and Microorganism Characteristics Cannot Predict Adverse Outcome in Pregnancies Complicated With Urinary Tract Infection. Infectious Diseases in Clinical Practice. 2021; 29: 23 - 26.
XV. Nalam N, Gopalan U. Effect of asymptomatic bacteriuria on pregnancy outcome: a review. International journal of Reproduction, contraception, obstetrics and Gynecology. 2021; 10: 1 - 6.
XVI. Kruthipati R, Chethan R, Shiva C, Tejeswini K. A study to establish the prevalence of urinary tract infection in preterm labour. International journal of Reproduction, contraception, obstetrics and Gynecology. 2021; 10: 10 - 18.
XVII. Ciccarese F, Brandi N, Corcioni B, Golfieri R, et al. Complicated pyelonephritis associated with chronic renal stone disease. Abdominal Radiology. 2021; 126: 505 - 516.
XVIII. Sial S, Dette A, Memon F, Parveen K, Ahmer A. Risk Factors during Pregnancy for Asymptomatic Bacteriuria. Journal of Pharmaceutical Research International. 2021; 33:21 - 26.
XIX. Raj S, Sarmishta M. Maternal and Fetal Outcome of Fever in Pregnancy. Journal of Evolution of Medical and Dental Sciences. 2021: 10; 13 - 19.
XX. Szweda H, Jozwik M. Urinary tract infections during pregnancy - an updated overview. Developmental Period Medicine. 2017; 20: 263 - 272.
XXI. Kin S, Parikh P, King A, Marnach M. Asymptomatic Bacteriuria in Pregnancy Complicated by Pyelonephritis Requiring Nephrectomy. Case reports in Obstetrics and Gynecology. 2018; 1 - 4.
XXII. Gozdas H, Dinek M. Persistent fever during treatment of a pregnant woman with acute pyelonephritis. Journal of Acute Disease. 2017; 6: 41 - 44.
XXIII. Zanatta D, Rossini M, Junior A. Pyelonephritis in Pregnancy: Clinical and Laboratorial Aspects and Perinatal Results. RBGO. 2017; 39: 653 - 658.
XXIV. Khati A, Murphy N, Osborn M, Garber K, Hecker K. Community-Asquired Pyelonephritis in Pregnancy Caused by KPC-Producing Klebsiella pneumoniae. Antimicrobial Agents and Chemotherapy. 2017; 59.
XXV. Johnsson J, Russo T. Acute pyelonephritis in adults. N Engl J Med. 378: 48 - 59.
XXVI. Aida A, Zeinep B, Bayan S. Ways of Prognosis and Reduction of Obstetric and Perinatal Complications at Pregnancy Chronic Pyelonephritis. Biomedical & Pharmacology Journal. 2017; 10: 535 - 547.
XXVII. Tzelves L, Tuk C, Skolarikos A. European Association of Urology Urolithiasis Guidelines: Where Are We Going?. European Urology Focus. 2021; 7: 34 - 38.
XXVIII. Clennon E, Pare E, Amato P, Caughey A. Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study. ajog. ajog. 2018.
XXIX. Tan S, Chen X, Sun M, Wu B. The comparison of effects and safety of double-J stent retention and ureteroscopy lithotripsy in the treatment of symptomatic ureteral calculi during pregnancy. ejog. 2018; 227: 32 - 34.
XXX. Renato P, Das K, Buchholz N. Urolithiasis in pregnancy. International Journal of Surgery. 2017; 36: 688 - 692.
XXXI. Tan S, Chen X, Sun M, Wu B. The comparison of effects and safety of double-J stent retention and ureteroscopy lithotripsy in the treatment of symptomatic ureteral calculi during pregnancy. ejog. 2018; 227: 32 - 34.
XXXII. Levin G, Safrai M, Sabag L, Khatab A, Rottenstreich A. Reply to The comparation of effects and security of double-J stent retention and ureteroscopy lithotripsy in the treatment of symptomatic ureteral calculi during pregnancy. ejog. 2018; 229: 198 - 199.
XXXIII. Kashif U, Riaz N, Percholi S, Iles D. Urogynaecological complications in pregnancy. Obstetrics, Gynaecology and Reproductive Med. 2021: 42 - 47.
XXXIV. Priyanka h, Basu M. Urinary tract infection in gynaecology and obstetrics. Obstetrics, Gynaecology and Reproductive Med. 2020: 276 - 282.
XXXV. Fontenelle L, Sarti T. Kidney Stones: Treatment and Prevention. American Family Physician. 2019; 99; 491 - 496.
XXXVI. McCarthy C, Baliyan V, Hamed H, Sajjad Z, et al. Radiology of renal stone disease. International Journal of Surgery. 2017; 36: 638 - 646.
XXXVII. Navarro A, Puno J, Gopez J, Tiongo R. Reducing the incidence of pregnancy-related urinary tract infection by improving the knowledge and preventive practices of pregnant women. ejog. 2019; 241: 88 - 93.
XXXVIII. Minyao D, Haleem M, Mamuchasvhlli A. Medical evaluation and pharmacotherapeutical strategies in management of urolithiasis. Therapeutic Advances in Urology. 2021; 13: 10-18.