Pyelonephritis in Pregnancy

Pyelonephritis refers to a condition in which the uppermost section of your urinary tract becomes infected. It usually affects women with asymptomatic urinary tract, but studies have found a risk ratio of 14 to 1,000, which implies that every 14 in 1,000 pregnant women are diagnosed with acute pyelonephritis. Research also shows that 70% of cases can be avoided through subsequent treatment for bacterium found in urine.

Why Does Pyelonephritis in Pregnancy Occur More Often?

Pyelonephritis usually affects women and is relatively more common in pregnant women as compared women who are not pregnant. This usually happens due to physiological changes that take place during pregnancy. These changes may obstruct the flow of urine, which increases risk of infections.

Under normal circumstances, the ureters take urine from the kidney and empty into the bladder, from where it goes out of your body through the urethra. There may be a change in the contraction of these drainage ducts due to an increase in the levels of progesterone.

Similarly, the uterus becomes enlarged as your pregnancy progresses, and this growing uterus may start to put more pressure on the ureters. This will again cause problems with proper drainage of the urine. Once your body fails to eliminate urine, it provides bacteria in the bladder a chance to move to the kidneys and cause an infection. It is due to these reasons that pyelonephritis in pregnancy is more common.

What Are the Symptoms of Pyelonephritis?

You usually develop pyelonephritis when the bacteria Escherichia coli (E. coli) cause an infection, but other bacteria like the Proteus species, Klebsiella penumoniae, and Staphylococcus can also cause kidney infections. When you become infected, you do not usually experience symptoms right away. You experience signs of severe illness when the infection spreads to the kidney. The most common symptoms are fever, back pain, feeling sick, confusion, nausea, and vomiting.

You may also notice changes in the urine when you develop pyelonephritis in pregnancy. For instance, you experience pain when urinating, notice blood in the urine, and have foul-smelling urine. Frequent urination is yet another sign of pyelonephritis.

Complications Associated with Pyelonephritis in Pregnancy

Symptoms may become severe when you do not seek immediate medical treatment. If left untreated, pyelonephritis can lead to other pregnancy related complications. The most common are anemia, respiratory distress, and impaired kidney function. About 20% of cases result in septic shock with serious kidney and respiratory malfunction. About 5% of pregnant women with pyelonephritis suffer preterm delivery.

What Is the Treatment for Pyelonephritis in Pregnancy?

As mentioned already, it is important to seek treatment immediately after experiencing symptoms. Talk to your doctor who will consider your signs and symptoms to determine the most appropriate treatment option.

Antibiotic Medicines

The most common treatment option involves giving patients intravenous (IV) antibiotics. You usually need to take these antibiotics until your fever goes away. Fever usually indicates that you still have an active infection. However, some doctors will check your urine and only discharge you if they get a negative urine culture. You still need to complete your antibiotic treatment after you have been discharged from the hospital.

Your doctor will change antibiotics if IV antibiotic treatment does not produce desired results within 48 hours. They will perform another urine test to ensure there are no other types of infections. You may require additional IV antibiotic treatment if your urine culture shows presence of pyelonephritis-causing bacteria.

Drinking Fluids

It is important to drink plenty of water and fluids to stay hydrated. Drinking plenty of water will help increase urinary flow and make it difficult for organisms to multiply in the urine. It is important to keep in mind that drinking too much of water may dilute any antibiotic in the urine. Be sure to talk to your doctor to know how much fluid to drink. You may require intravenous fluids if you vomit a lot.

Future Prenatal Care

Even when you have recovered, it is important to have a urine test done at least once a month to ensure you do not develop pyelonephritis in pregnancyagain. If it reoccurs, you may have to take oral antibiotics for the duration of your pregnancy. Your doctor will select a strong course of antibiotics to treat pyelonephritis if it reoccurs.

How Can You Prevent Pyelonephritis in Pregnancy?

You can take a number of steps to prevent this condition. For instance:

  • Increase your fluid intake. Drink several glasses of water daily because it hampers the growth of infection-causing bacteria by improving urinary flow. This flushing also plays a big role in preventing kidney stones.
  • Whenever using toilet, you should wipe from front to back and not the other way round. This ensures you do not contaminate your urinary tract with intestinal and skin bacteria.
  • Be sure to urinate after you have sex with your partner. This helps eliminate bacteria from the bladder. You can even take antibiotics if you often develop infections after sexual activity.
 
 
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