Particularities of the evolution of acute obstructive pyelonephritis in pregnancy

Abstract

Introduction. From the common complications of pregnancy, most often infections of the urinary tract (UTI) are met, these due to physiological and anatomical changes during pregnancy, which mostly leads to the development of urinary tract infection. Another important factor is the pregnant uterus that mechanically compresses the ureters and leads to urinary stasis. Aim of the study. Evaluation of the particularities of the evolution of acute obstructive pyelonephritis in pregnancy, the influence of infections on gestational duration, on childbirth and the particularities of the diagnostic plan. Materials and methods.. The study selected information from the medical record and perinatal notebook of each pregnant woman who is urgently hospitalized in the Urology Department ofthe Municipal Clinical Hospital "Sf.Treime". According to the protocol, the examination plan was: anamnesis, the history of the current disease, pathological history; paraclinical investigations: general blood analysis, general analysis of urine, biochemical and functional renal samples; imaging investigations: ultrasound. Results. All pregnant patients with acute obstructive pyelonephritis hospitalized in the Municipal Clinical Hospital "Sf.Treime" were between 20 and 34 years of age, the studied group comprised 34 pregnant women, so 23 pregnant women were primiparous, and 11 - multiparous. According to the protocol, 18 patients initially experienced lower back pain, fever - 22 cases, nausea – 10 cases, vomiting – 8 cases. Also, the initiated treatment consisted of cephalosporin antibioticotherapy and the installation of JJ stent over a period of 14 days under the supervision of the gynecologist. Conclusions. 1. Treatment of Acute Obstrictive Pyelonephritis in pregnancy is an emergency one. 2. The determination of the pathogen by taking uroculture in the Emergency Department would result in more effective treatment, by isolating the pathogen and continuing monotherapy. 3. Draining urine from the source of infection should be carried out urgently, preferring minimally invasive and continued hydroelectrolytic rebalancing methods. 4. In case of installation of JJ stent, this is also a source of infection, the duration of antibiotictherapy should be extended. 5. Patients also require monitoring in the post-partum period, as the atonia of the urets persists up to 5 weeks post-partum.