Pyelonephritis in pregnancy

Pyelonephritis is a pathology of the kidneys of infectious origin, in which the structure of the organ is disturbed. Against the background of inflammation the outflow of urine worsens, the illness is accompanied by pain, sometimes with high temperature. Pyelonephritis during pregnancy occurs frequently, it may be primary, but more often diagnose exacerbation of chronic inflammation of the kidneys. How to treat pyelonephritis during pregnancy? How dangerous is the disease for mother and child?

Gestational pyelonephritis

Pyelonephritis in pregnant women diagnosedabout 10% of women. The main causes are weakened immunity, pressure of the uterus on the kidneys, changes in the hormonal background. The code for the ICD-10 is O23.0( infection of the kidneys during pregnancy).

As the fetus grows, the uterus grows in size - the anatomical structure of the kidneys changes under pressure, blood circulation worsens, urine deteriorates worse. Against the background of hormonal changes in the body, muscle tone changes - urodynamics are disrupted, urine from the bladder is thrown back into the kidneys. If there are pathogenic microorganisms in the urine, the inflammatory process in the kidneys begins.

Important! Any infectious disease can cause inflammation in the organs of the genitourinary system.

Inflammation of the kidneys in pregnant women is called gestational pyelonephritis - the disease develops during the gestation of the child, it may appear several days after the birth. Most often the inflammatory process is localized in the right kidney.

Gestational pyelonephritis is most common in primiparous women, with polyhydramnios, bearing two or more children, a large fetus. The disease often occurs without clear symptoms, signs are similar to placental abruption, a threat of miscarriage. The diagnosis can be made only after the tests.

Indications for hospitalization for pyelonephritis in pregnant women:

• acute pyelonephritis, exacerbation of chronic form;
• kidney failure;
• gestosis, which develops against the background of inflammation of the kidneys;
• threat of miscarriage, premature birth;
• if the test showed deterioration of the fetus.

Pyelonephritis appears more vivid in the first trimester than in late pregnancy. Adequate treatment at the initial stage of the disease will help to quickly eliminate the inflammatory process, the risk of complications is minimal. If gestational pyelonephritis occurs against a background of hypertension, anemia, functional kidney damage - this poses a serious threat to the life and health of the mother and child.

Symptoms of chronic and acute pyelonephritis

Pyelonephritis is an infectious disease that occurs when infected with E. coli, bacteria. With the blood flow along the ascending or descending pathways, pathogenic microorganisms penetrate the kidneys. The weakened immunity of a pregnant woman can not fight them, inflammation develops.

Acute pyelonephritis is accompanied by severe pain in the lumbar region, which gives in the leg, abdomen, buttocks. Urination becomes painful, the temperature rises sharply, sweating increases. In primiparous women, the disease can occur for 16-20 weeks, in re-birth - for 25-32.

The main symptoms of acute pyelonephritis:

• increase in body temperature to 38-39 degrees;
• urine becomes turbid;
• permanent low back pain with one or both sides;
• chills, joint pain, muscle.

Chronic pyelonephritis occurs without any symptoms, which can be very dangerous for a pregnant woman. The clinical analysis of blood and urine will help to establish the diagnosis. The development of the inflammatory process in the kidneys may be indicated by dull pain in the lumbar region, the presence of protein in the urine.

Important! Exacerbation of chronic pyelonephritis during pregnancy can cause miscarriage, premature delivery, fetal death in the womb.

Than pyelonephritis is dangerous during pregnancy

Important! Pyelonephritis is subject to mandatory treatment during pregnancy - antibiotics cause less harm. The inflammatory process in the kidneys.

How does pyelonephritis affect pregnancy? In pregnant women with inflammation of the kidneys, there is almost always a severe form of gestosis - this can cause severe consequences for the child.

Threatens pyelonephritis during pregnancy:

• Premature abortion - permanent or severe pain syndrome stimulates contraction of the uterine myometrium;
• infection of the fetus in the womb - in the early stages of pregnancy the placenta is not yet fully formed, the infection penetrates the fetal tissues, pathologies of development occur;
• oxygen starvation - on the background of pathological changes in the kidneys, hypoxia and fetal asphyxia occur.

If a woman underwent pyelonephritis during pregnancy, often newborns have low weight, prolonged jaundice, hypothermia, central nervous system pathologies.

Important! The consequence of pyelonephritis in the early stages is the death of a child in the early postpartum period.

Because inflammation of the kidneys often develops into a chronic form, pregnancy after pyelonephritis is under constant monitoring by a doctor, a woman is recommended to go to a hospital in the first and third trimester.

Diagnostics

Early diagnostics helps to minimize the negative consequences of the disease, to transfer pathology to the stage of persistent remission. After external examination and analysis of complaints, the doctor prescribes a comprehensive, comprehensive examination.

Methods of diagnosis:

• clinical analysis of urine - the presence of protein, bacteria, high level of leukocytes indicates the inflammatory process;
• urine analysis according to Nechiporenko, according to Zimnitskiy - shows the white blood cell count, the presence of protein and blood impurities;
• urine culture to identify the type of pathogenic microorganisms - carried out three times;
• clinical blood test - inflammation is indicated by high ESR, low hemoglobin, high content of immature leukocytes;
• Ultrasound is conventional and with doppler.

If a pyelonephritis is suspected, the gynecologist gives a referral for tests and advice from a nephrologist. Further treatment of renal inflammation will take place in a hospital under the supervision of both specialists.

Important! Pyelonephritis does not belong to the basic indications for caesarean section.

Peculiarities of treatment in pregnant women

In case of kidney pyelonephritis, pregnant women should observe bed rest, avoid stress, heavy physical exertion. To improve the outflow of urine, several times a day, lie down on one side, opposite the inflamed kidney - the legs should be slightly above the head. If the improvement is not observed within 24 hours - a woman will have a catheter.

Antibiotics for the treatment of inflammation of the kidneys are mandatory, their choice depends on the gestational age, the form and severity of the disease. In addition, prescribed uroantiseptics, pain medications, antispasmodics. The scheme of treatment is appointed by the doctor individually.

Essential Medicines for the Treatment of Inflammation of the Kidney:

1. In the first trimester, antibiotics are prescribed in extreme cases, since the placenta does not yet fully protect the fetus. During this period it is allowed to use antibiotics of the penicillin group - Ampicillin, Amoxiclav.
2. In the second trimester, the use of stronger antibacterial agents from the group of cephalosporins II, III generation - Cefazolin, Supraks is allowed. These funds can be taken up to 36 weeks, the duration of therapy is 5-10 days.
3. From the 16th week, if necessary, Nitroxoline can be used.
4. With lesions of the kidneys staphylococcus macrolides can be used - Sumamed, Eritoromitsion.

Important! It is strictly forbidden to carry out treatment during pregnancy with fluoroquinolones( Nolitsin), preparations based on tetracycline, you can not take Biseptol, Levomycitin.

Great value during treatment is proper nutrition, compliance with drinking regimen. Diet with pyelonephritis in pregnant women implies a complete rejection of spicy, salty, fatty, smoked, fried foods. It is not recommended to eat foods that irritate the walls of the bladder - radish, spinach, sorrel. Bread better is a little dried, preference given to products from wholemeal flour.

You need to drink at least 2 liters of fluid per day. The best drinks for pregnant women are cranberry fruit juice, broth of wild rose, mineral water without gas.

Treatment with folk remedies

Phytotherapy will help to increase the effectiveness of medicines, pyelonephritis is treated with plants that have a diuretic and anti-inflammatory effect.

How to treat pyelonephritis with herbs? First you need to remember which plants are forbidden to use during pregnancy:

• juniper berries;
• root and parsley seeds;
• Bearberry;
• licorice;
• yarrow.

Oat broth is a universal remedy for treating kidney inflammation. It must be prepared from cereals - pour 180 grams of cereals 1 liter of water, simmer for 2-3 hours on a small fire. Take oatmeal medicine on an empty stomach for 120 ml 2-3 times a day.

Pumpkin is a healthy vegetable with a powerful anti-inflammatory effect. From it you need to make juice, cook porridge, eat raw and boiled.

Broth of dogrose - an indispensable drink for pregnant women, which strengthens the immune system, has a diuretic and anti-inflammatory properties. In 1 liter of boiling water to fill 100 dried berries, simmer on low heat for 5 minutes in a closed container. Infuse 3 hours, drink the whole portion of broth throughout the day.

The infusion of thyme helps to quickly eliminate pain and inflammation. Pour 220 ml of boiling water 5 g of dry raw material, leave for 20 minutes. Take 15 ml 3-4 times a day in a strained form. The duration of treatment is 7-10 days.

Prevention of

Pregnant women should know not only how to treat pyelonephritis, but also how to prevent the appearance of the disease, its aggravation. You need to regularly visit a gynecologist, take tests of urine and blood. To prevent exacerbation in chronic renal inflammation from 12-13 weeks, you can take urological herbal preparations - Kanefron N, Brusniver.

If a history of chronic diseases of the urinary system, then a special diet should be adhered to the most genera. Pregnant to prevent stagnation of urine to empty the bladder every 3-4 hours.

It is necessary to avoid hypothermia, not to visit crowded places during epidemics, regularly perform gymnastics for pregnant women, swim, make walks for 30-40 minutes every day.

Pyelonephritis during pregnancy is a difficult and dangerous disease, dangerous for a woman and a child. It is necessary to treat the disease, because the infection can cause the death of the child. Timely diagnosis, the implementation of the doctor's recommendations will help to avoid exacerbation and relapse of renal inflammation.