incidence of pyelonephritis in pregnant women ranges from 2-10%, and it can occur not only during pregnancy but also during and after childbirth, that is, during the entire so-called gestational period (the word gestation - pregnancy), including childbirth and the postpartum period, so in some cases it is called: "gestational pyelonephritis."
Gestational pyelonephritis and types
pyelonephritis - an inflammation of the kidney tissue with a primary lesion of the interstitial tissue (connective bases kidneys) and renal pelvis system (cavities in the kidney where urine flows before they get into the ureter).
Gestational pyelonephritis divided into pyelonephritis pregnant, maternal pyelonephritis (during birth) and pyelonephritis women in childbirth (postpartum), and has its own characteristics and trends of development.Causative agents of pyelonephritis pregnant often are microorganisms such as E. coli, Klebsiella, and Proteus;puerperas - enterococci and Escherichia coli.
in the formation of gestational pyelonephritis big role belongs to the hormonal changes in a woman's body.Qualitative and quantitative changes in the composition of various hormones (female sex hormones estrogen Estrogen - the key to healthy bones and progesterone Progesterone - norm and pathology , adrenal hormone hydrocortisone), squeeze kidney growing uterus and the violation of their blood supply predispose topoor circulation and excretion of urine, kidney and promote infection of an inflammatory process, particularly in the presence of a woman's body any source of infection (e.g., chronic tonsillitis).
usually observed sided pyelonephritis, due to the feature of the structure of the venous system in this area.Most women fall ill during the first pregnancy.This is due to a lack of adaptation to occurring during pregnancy hormonal and immunological changes.For most women, pyelonephritis occurs in the late second - early third trimester (at 20-26 and 32-34 weeks of pregnancy), when there is the most significant hormonal changes.
pyelonephritis in women in childbirth often manifested in the 4-6 and 12-14 days after birth, that is, in those periods when there are postnatal complications.
How is pyelonephritis during pregnancy pyelonephritis
manifested in different ways at different stages of pregnancy.It depends on the degree of excretion of urine from the kidneys to the ureters.Thus, in the first trimester (first 12 weeks) observed severe pain in the lumbar region, the second and third trimester and postpartum women with pyelonephritis in pain less intense.In severe may increase the temperature and disrupted overall.
Acute pyelonephritis usually has no significant effect on the course of pregnancy, chronic pyelonephritis often reveals miscarriage Miscarriage - why you lose the most precious thing? , prematurity and pregnancy toxicosis.In acute pyelonephritis births occur spontaneously and do not require special procedures.In chronic pyelonephritis in 10% of cases had to resort to induction of labor.Cesarean section with pyelonephritis is permissible only if strict indications.
diagnosis of pyelonephritis in pregnancy
in the diagnosis of pyelonephritis in pregnant importance belongs to laboratory methods.In the blood of pregnant women usually show signs of inflammation - increase the number of cells with neutrophilic shift to the left, that is, with an increase in the number of young neutrophils, it is said that the body mobilizes its forces to fight the infection.The urine detected a large number of white blood cells and bacteria.Held as a urine culture to culture media to identify the pathogen and its sensitivity to antibiotics.
If there is suspicion of a violation of the passage (excretion) urine is held cystochromoscopy - examination of the bladder The bladder - structure and function with a special optical equipment with a preliminary introduction to the blood coloring material that colors the urine and to judgethe timeliness of its release.If a delay is detected expressed passage of urine, in some cases, a ureteral catheter in order to avoid serious complications from the kidney.
Treatment of pyelonephritis in pregnancy
Treatment of gestational pyelonephritis should be comprehensive, individually, taking into account the characteristics of its flow in pregnant and postpartum women.In order to avoid adverse effects on the fetus in the first trimester of pregnancy, only natural and semi-synthetic penicillins.In the second and third trimesters is possible to use some other group of antibiotics, anti-inflammatory drugs as well as other groups.
In addition, women are prescribed diuretics low toxicity, in some cases, blood products transfused.The success of treatment depends on the passage of urine.Since the inflammatory process often continues after the postpartum period, the woman must necessarily occur at the urologist.
Prevention of pyelonephritis of pregnant women is early detection and treatment of kidney disease in non-pregnant women.