Pyelonephritis during pregnancy: symptoms, treatment, consequences

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

From the moment when a woman discovers the treasured two bright stripes during a pregnancy test, there is no limit to joy. At the same time, the expectant mother is well aware that now she has a great responsibility, because the development of the child depends on what lifestyle she leads. Is it possible to wish bad things to your child?! But along with responsibility, any woman encounters some troubles and unexpected surprises. One of these circumstances is pyelonephritis during pregnancy. Interestingly, from a medical point of view, at any period of bearing a child, this disease is also called gestational.

What are the features of the course of this disease, what can cause pathology, and most importantly, how to treat? We will try to answer all these and some other questionsfind answers.

General information

Many people hear such a word as pyelonephritis, but not everyone is exactly aware of what is hidden behind this term. This definition implies an inflammatory process in the kidneys. To be more precise, it affects the connective tissues. In the future, the pelvicalyceal system (CHLS) is affected. At the same time, two forms of pyelonephritis are distinguished:

• Primary - appears just after a successful conception.
• Secondary - the woman had earlier, but worsened during pregnancy.

In most cases, it is the right kidney that undergoes inflammation, namely gestational pyelonephritis during pregnancy. This disease poses a serious threat to both mother and child. For this reason, it is necessary to know the symptoms of the pathology, as well as to understand why, in fact, it occurs.

As statistics show, women of childbearing age are susceptible to these serious diseases, and 6-12% are expectant mothers. Moreover, even if someone has not previously had he alth complaints, doctors can stun them with a disappointing diagnosis.

Development of pathology

How does such a dangerous disease develop? This question worries every woman, especially when the diagnosis has already been confirmed. In addition to the fact that there is a primary and secondary form of the disease, one should distinguish between the acute and chronic stages of this disease. And as it was noted at the very beginning of the article, gestational pyelonephritis during pregnancy is nothing more than the primary form of the disease, manifested only during gestationbaby.

At later stages of gestation, the risk of pathology increases. But if the disease is diagnosed in a timely manner, the necessary course of treatment is carried out, then a favorable outcome is guaranteed.

Pyelonephritis is an infectious disease, so it is important to know what causes it. It is equally important to understand what consequences everything can end with. But first, let's look at the symptoms.

Symptoms of pyelonephritis during pregnancy

Often, signs of kidney damage by an inflammatory process appear at 6 to 8 months of pregnancy. Basically, the clinical picture of acute pyelonephritis may look like this:

• Pain in the lumbar region that gets worse with long walking.
• Frequent urge to urinate.
• Chills.
• Headache.
• Nausea and vomiting.
• Fever.
• Muscle pain.
• Change in color of urine.
• Body temperature rises to 39°C or more.
• Signs of intoxication of the body.

During pregnancy, symptoms may appear in any of the trimesters. In this case, pain sensations of varying intensity can be given to the abdomen or thigh. The acute form of the disease is characterized by the fact that the pain increases with any movement, be it a cough or a deep breath.

Symptoms of pyelonephritis during pregnancy of an acute form make themselves felt suddenly, and body temperaturerises sharply and mainly in the evening, there is severe pain in the lumbar region.

In this case, it is necessary to call an ambulance in a timely manner, after which the woman will be urgently hospitalized and medical assistance will be provided to her. Treatment is usually carried out in a hospital setting. With proper treatment, after 1-2 weeks, all signs of the disease will disappear.

Chronic stage of the disease

If inflammation of the kidneys is chronic, then signs of this may be:

• Lower pain.
• Constant discomfort.
• Feeling weak.
• Tired and lethargic.
• Subfebrile body temperature.

Chronic pyelonephritis during pregnancy differs in that it proceeds sluggishly, and periods of remission and exacerbation occur only periodically.

The pains are usually not so strong, although they can increase with movement. With little physical activity, fatigue increases. As medical practice shows, often chronic pyelonephritis can be detected during a routine ultrasound.

The peculiarity of this stage of the disease is that it can worsen at any time, since there are plenty of factors for this. Take though the fact that the immunity of a woman during pregnancy is weakened, especially at the initial stage. Therefore, if chronic inflammation of the kidneys is detected, the expectant mother is now under the vigilant supervision of a doctor.

What could be causing it?

Of course, likeany other disease, pyelonephritis does not occur just like that and there are reasons for this. Interestingly, the process of bearing a child in itself may be the root cause of the onset of symptoms of pyelonephritis in women during pregnancy. Here's why.

With the growth of the fetus, the uterus also increases in size. There may come a time when the reproductive organ begins to touch the ureters, squeezing them. As a result, the exit of urine is already difficult. And the larger the uterus becomes, the stronger the pressure. It also contributes to a change in the hormonal background of the female body. However, this is just one of the factors, the causative agents of the disease itself are:

• E. coli;
• gram-negative ecterobacteria;
• Pseudomonas aeruginosa;
• proteus;
• enterococcus;
• Staphylococcus aureus;
• streptococcus;
• A fungus like Candida.

All these microorganisms and bacteria come from outside, but some of them are permanent residents of the human body. And in most cases, the pathogens of this dangerous disease enter the kidneys by the hematogenous route. Infection through the urinary tract is extremely rare.

There is another factor in favor of pyelonephritis in early pregnancy. During this period, the placenta actively produces estrogens, which, without knowing it, form a favorable environment for some infectious pathogens. In particular, we are talking about E. coli.

Dangerous Consequences

Like any infectious diseasenature, pyelonephritis negatively affects the course of pregnancy. In the absence of proper treatment, inflammation affects the deeper tissues of the kidneys. In turn, this leads to glomerulonephritis, and as a result, everything ends with renal failure. Sometimes a phlegmon or kidney abscess may begin to develop. Fortunately, this rarely happens. However, hardly anyone wants to fall into this risk group.

The complications described above concern the woman directly. But you need to understand that the child is also at risk. The consequences of pyelonephritis during pregnancy in this case are also disappointing:

• Embryo death in early pregnancy.
• Premature delivery.
• Fetal hypoxia.
• Intrauterine infection.

As you can see, it doesn't end well. The child may die, but if he survives, he will be born prematurely, with low birth weight. Or he may have severe neurological abnormalities.

Diagnosis of disease

If, under normal circumstances, diagnosing pyelonephritis is not difficult, then there are some difficulties in relation to pregnant women. First of all, this is due to the fact that the use of most diagnostic methods is very limited. And first of all, this applies to radiation equipment, because of which the child will develop leukemia.

In this regard, the diagnosis of pyelonephritis during pregnancy is confirmed or refuted on the basis of laboratoryresearch, including:

• Complete blood count and biochemistry - will show the number of leukocytes, which is greatly increased during the inflammatory process. Also, such a characteristic as the erythrocyte sedimentation rate will be determined (in case of pathology it is high).
• General urinalysis - allows you to determine if there are white blood cells, proteins, bacteria.
• Urine analysis according to Nechiporenko - here, too, it all comes down to the detection of a large number of leukocytes, which confirms the presence of pyelonephritis.
• Zimnitsky's test - in this case, the ability of the kidneys to concentrate urine is determined. With pathology, this ability is significantly reduced.
• Ultrasound - this examination will reveal structural changes in the pelvic organs.

With such an integrated approach, it is possible to establish an accurate diagnosis, and, if necessary, to identify pyelonephritis during pregnancy, which occurs in a latent form. As for instrumental methods for diagnosing pyelonephritis, they are not used because of the high risk of infection. In particular, this refers to the catheterization of the ureters and bladder.

How the treatment works

When pyelonephritis is detected in a pregnant woman, the primary task is to restore the outflow of urine. To do this, it is necessary to relieve the pressure of the uterus on the kidneys and urinary tract. This is where positional therapy can help. That is, the expectant mother spends most of her sleep on her back, and in the supine position on her side, mostly on the left. Take several times during the dayknee-elbow position and stay in this position for 5-15 minutes.

In the event that the outflow of urine is restored or has not been disturbed, the doctor prescribes a course of treatment for pyelonephritis during pregnancy, which is based on:

• antibiotics;
• phytopreparations;
• herbal preparations;
• antispasmodics;
• diuretics.

Moreover, the therapy is individual in each case.

Treatment of incipient pyelonephritis usually comes down to phytotherapy using kidney fees, kidney tea. A good remedy is considered to be a decoction of wild rose or lingonberry leaf. If the disease is diagnosed in the first trimester, then the doctor prescribes antibiotics only in extreme cases.

In the acute form of pyelonephritis, the treatment course consists of taking drugs belonging to the group of penicillins, aminoglycosides, cephalosporins and macrolides. As for tetracyclines and streptomycins, pregnant women are strictly forbidden to take them.

In order to avoid exacerbation of pyelonephritis during pregnancy, only the attending physician should be engaged in the selection of the necessary drugs. To do this, the first step is to determine the category of the pathogen, as well as its sensitivity to a particular antibiotic.

Treatment of chronic pyelonephritis is postponed to the postpartum period, but during pregnancy a woman is always under observation. At the same time, expectant mothers with these diseases have to be tested more often than he althy ones.pregnant.

Folk remedies

Along with traditional drug treatment, time-tested folk remedies can also help to cope with pyelonephritis. The following "drugs" are highly effective:

• Decoction of corn stigmas. A tablespoon of raw materials (corn stigmas) is poured with a glass of boiled water, after which the mixture is boiled over low heat for 20 minutes. Then the broth is infused for 30 minutes and it can be used. Strain just before use. Take the remedy should be 2 tbsp. spoons with a three-hour break. At the same time, it is necessary to follow a s alt-free diet and limit fluid intake.
• Effectively fight pyelonephritis in women during pregnancy helps infusion of yarrow. Two teaspoons of chopped herbs are poured with boiling water (1 tablespoon), then let it brew (60 minutes). Take in the amount of 3 tbsp. spoons 5 times a day.
• Cornflower tincture. A teaspoon of flowers is poured with boiling water in the amount of 1 cup, then let it brew for 2 hours (preferably in a thermos). Take a quarter cup 3 times a day 20 minutes before meals. This remedy has a diuretic effect, so it can be used for swelling, which is caused by inflammation of the urinary system.

Only in no case do not self-medicate, as this leads to irreversible consequences.

As for the listed folk remedies, it is desirable before using them,consult your doctor to avoid unwanted complications.

Measures to prevent pyelonephritis during pregnancy

The need for prevention to prevent any kind of disease is unlikely to be challenged by anyone. You can avoid the appearance of an unwanted disease, for which useful recommendations serve:

• Personal hygiene.
• Eat a he althy and balanced diet.
• If you want to use the toilet, do not endure!
• Most of the time spent outdoors.
• If possible, avoid hypothermia.
• If a woman has any diseases that are still in an acute form, they should be treated. And before conception, otherwise there may be problems later in case of their exacerbation.
• Sometimes boost your immunity.
• In the absence of swelling of the legs, consume more fluids, but within reasonable limits. And this is 2 liters per day, including soups, kissels and juicy fruits.
• It is useful for pregnant women to do special exercises that will reduce pressure on the pelvic organs, including the kidneys.
• Regularly take all the necessary examinations.

Well, and most importantly, the first signs of pyelonephritis during pregnancy should not be ignored in order to exclude its further development.

After all, every woman wants, in the end, to hug a he althy, full and happy child. For any mother, this will be the best reward!