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Pyelonephritis in pregnant women: symptoms and diagnostic methods. Consequences of pyelonephritis during pregnancy: acute and chronic pyelonephritis, treatment methods

Pyelonephritis is an inflammatory process in the kidneys that is quite common in pregnant women. According to statistics, 6-12% of women with pyelonephritis for the first time are pregnant women.

Pyelonephritis can be primary (when it is diagnosed for the first time during pregnancy) and secondary (when the woman had the disease before conception and worsened during pregnancy). Pyelonephritis that develops during pregnancy is called gestational pyelonephritis. Most often, this disease manifests itself at the end of the second trimester.

Causes of pyelonephritis in pregnant women

Pregnancy is a provoking factor causing an exacerbation of the disease, since the main reason for the development of gestational pyelonephritis is mechanical.

The uterus that enlarges during pregnancy puts pressure on nearby organs, including the kidneys and ureters, making it difficult for urine to pass through them.

Another serious factor is hormonal changes in the female body. A change in the balance of hormones in the body, primarily estrogens and progesterone, leads to a deterioration in the peristalsis of the ureters.

The consequence of these physiological reasons is stagnation of urine in the renal pelvis, which is a favorable environment for the reproduction of pathogenic microorganisms (staphylococci, streptococci, Escherichia coli) and leads to the development of an infectious and inflammatory process in the ureters and kidneys.

To a greater extent, pregnant women who have previously suffered from pyelonephritis or cystitis are predisposed to gestational pyelonephritis. Also, the provoking factors include lowered immunity, frequent hypothermia and a sedentary lifestyle.

The main symptoms of the disease usually make themselves felt from 22-24 weeks of pregnancy. The severity of symptoms depends on the form of the disease - acute or chronic.

In the acute form of pyelonephritis, there is:

  • Temperature increase;
  • Severe chills with high fever;
  • Nausea, vomiting, decreased appetite;
  • Headache;
  • Muscle aches;
  • Increased breathing and heart rate;
  • Back pain.

Lethargy is noted between chills, pain intensification usually occurs at night. Lower back pain can radiate to the upper abdomen, to the perineum, and thigh. The pain may increase with movement and physical exertion, in the position of the patient on his back or on the side opposite the diseased kidney, with a cough or deep breath.

In the chronic form of pyelonephritis, dull aching pains in the lumbar region disturb, general weakness, lethargy, and fatigue are observed.

When self-diagnosed, gestational pyelonephritis is often confused with the threat of miscarriage. In any case, even with minor symptoms, you should immediately contact the clinic.

Possibly asymptomatic course of gestational pyelonephritis. In this case, it is detected only as a result of appropriate analyzes.

To make a diagnosis, the following series of studies are assigned:

  • General blood analysis: with severe pyelonephritis, the level of leukocytes and ESR increases, the level of hemoglobin decreases;
  • Blood chemistry to determine the amount of urea and creatinine;
  • General urine analysis: protein and leukocytes can be found in the urine, possibly a small amount of blood;
  • Bacteriological examination of urine: to accurately determine the causative agent of the infection and establish its sensitivity to antibiotics;
  • Kidney ultrasound: the affected kidney is usually enlarged and has an altered structure;
  • Nephrology consultation;
  • Ureteral catheterization: performed both for diagnostic and therapeutic purposes, under ultrasound control.

In each case, the scope of diagnostic studies is determined individually after examining the pregnant woman.

Acute pyelonephritis and exacerbations of its chronic form are treated only in a hospital. In this case, you need to act immediately.

Antibacterial therapy is mandatory. In this situation, their use is justified and bears less harm to the mother and child than the consequences of the disease. Antibiotics must be selected very carefully and combine maximum effectiveness and relative safety for the unborn child.

Preference is given to antibiotics of the penicillin series(Ampicillin, Meticillin, Oxacillin), the use of which is permissible in the first trimester, cephalosporins (Zeporin, Suprex), permissible in the second and third trimester, aminoglycosides (Netilmicin), macrolides (Erythromycin).

Antibiotics of chloramphenicol, streptomycin and tetracycline series, sulfonamides, fluoroquinolones, furazolidone, biseptol are categorically contraindicated during pregnancy. Their use can seriously harm the health of the child, cause damage to bone tissue, blood-forming organs, and the vestibular apparatus. A specific drug is prescribed after determining the type of infectious agent, the course of treatment is 10-14 days.

To enhance the effect of taking antibiotics, antimicrobial drugs and uroantiseptics are prescribed in parallel. All pregnant women, regardless of the form of the disease, are prescribed antispasmodics and pain relievers.

Complex treatment includes desensitizing agents (Diazolin, Tavegil, Suprastin), sedatives (tinctures of valerian or motherwort), vitamins of group B, C and PP, phytopreparation Kanefron.

Treatment of pyelonephritis begins with the restoration of violations of the outflow of urine. For this purpose, the so-called "positional therapy" is carried out: the pregnant woman lies on the side opposite the diseased kidney, taking a bent knee-elbow position. One edge of the bed, on which the legs are located, rises.

In this position, the uterus is deflected, and its pressure on the ureters decreases. If the situation does not improve during the day, catheterization of the ureter of the diseased kidney is performed under ultrasound control. In most cases, the result is positive.

If this does not occur, urine is drained from the kidney using a catheter inserted through the skin directly into the affected kidney.

In rare cases, with purulent complications, when there is a threat to the life of the mother and child, decapsulation of the kidney (removal of its fibrous capsule) or nephrectomy (removal of the kidney) is done. At the same time, the issue of maintaining pregnancy is being resolved. As a rule, the pregnancy must be terminated.

In chronic pyelonephritis with a normal urinalysis, there is no need for hospitalization. Pregnant women receive general advice regarding regimen and diet.

During the period of exacerbation, you should adhere to bed rest. Outside the stage of exacerbation in chronic pyelonephritis, it is recommended to lead a mobile and active lifestyle.

Possible complications of pyelonephritis during pregnancy:

  • Miscarriage;
  • Intrauterine infection or fetal death;
  • Premature birth;
  • The development of gestosis, which leads to an increase in blood pressure, edema and proteinuria;
  • Renal failure in a pregnant woman.

Timely treated pyelonephritis does not pose a serious danger to the development of pregnancy. Otherwise, the risk of miscarriage increases. Termination of pregnancy most often occurs at 16-24 weeks. If the pregnancy is preserved, the child after birth may have signs of intrauterine infection, ranging from conjunctivitis and ending with damage to the lungs, kidneys and other organs. Also, pyelonephritis is the cause of the development of late toxicosis and severe anemia.

Prevention of pyelonephritis

  • It is important to follow a diet that excludes spicy, salty, smoked, fried foods, seasonings and spices. Drink large quantities of compotes, fruit drinks, natural juices, herbal teas and teas with a diuretic effect to flush the kidneys;
  • Active walking for at least 30 minutes a day is recommended;
  • Avoid hypothermia;
  • Consume at least 2 liters of fluid per day (if there is no risk of edema);
  • Empty the bladder regularly, every 3-4 hours;
  • Eliminate all possible foci of infections in the body (caries, tonsillitis, genital infections);
  • Take tests at least 2 times a month.

Pyelonephritis in pregnant women occurs for various reasons, and this type of disease is called gestational. Pregnant women suffer from this ailment due to the occurrence of problems in the urinary system, where in the first place an infection can arise, which provokes the disease. Also, any inflammatory process in the body, whether it be a dental infection, stimulates gestation. The consequences of pyelonephritis during pregnancy may not be the best, but with treatment they can be avoided.

Causes of pyelonephritis

  • Difficulty urinating due to the growth of the uterus. It puts pressure on the bladder, thereby complicating its work.
  • Hormonal changes.
  • The postponed disease of pyelonephritis, cystitis in childhood or before pregnancy flares up again.
  • Reduced immunity, hypothermia and a sedentary lifestyle.

Types of pyelonephritis

The manifestation of the disease is divided into two types:

  • primary
  • secondary

The primary disease occurs when there is a change in the work of urination. In this case, kidney disease is not observed.

A secondary ailment of pyelonephritis is caused by inflammation of the urinary tract. Secondary pyelonephritis occurs in two phases:

  • Acute pyelonephritis - flares up suddenly, symptoms manifest themselves in a few hours, up to a couple of days. With proper treatment, within three weeks, the patient is on the mend.
  • Chronic pyelonephritis - manifests itself slowly, occurs due to bacteria that excite the process of inflammation. In case of not timely treatment of an acute disease, the disease becomes chronic. The focus of the onset of a chronic ailment is non-functional kidney function and arterial hypertension.

Influence of pyelonephritis on the unborn child.

First of all, there is a great possibility of transmission of the disease to the child. The baby may have pathologies in the development of the heart and kidneys. Immunity becomes weakened, the consequences for the child will not be the best, which will lead to frequent colds.

Pyelonephritis in a pregnant woman develops oxygen deficiency in the fetus, which also interferes with the proper development of the baby's organs. For this reason, babies are born underweight and weak. Doctors also note more serious consequences of the disease:


  • Damage to the central nervous system;
  • Jaundice - long term;
  • The baby's body temperature is lower than required.

The effect of pyelonephritis on the fetus

It is very important to turn to specialists in time for help. Timely treatment will lead to the salvation of both the mother and the fetus. So, in almost ninety percent of cases, it is possible to maintain a pregnancy, which is complicated by an illness. If you do not follow the treatment, the danger to the fetus is on the face. Let's highlight the main consequences:

  • Transmission, from mother to child, of an infectious disease;
  • Fetal hypoxia;
  • Inflammation of important internal organs of the baby;
  • Manifestation of conjunctivitis;
  • Improper development of organs;
  • Malnutrition of the fetus, as a result of the manifestation of gestosis in a pregnant woman, due to which the correct blood circulation of the brain, heart, kidneys, placenta is disturbed.

Pyelonephritis treatment

· Positional therapy;

· Medicinal treatment.

Positional therapy

Simple rules of conduct must be followed:

· A pregnant woman should not sleep on her back, but prefer to sleep on her left side.


· At 20 weeks, apply the knee-elbow position, which will alleviate the condition of the pregnant woman. It is useful to hold such an event several times a day, for fifteen minutes. For an illustrative example, see the photo at the link below.

· Drink a normal amount of liquid, up to three liters per day, if there are no contraindications. It can be: compote, jelly, water, but not tea or coffee.

· Do not consume urinary teas and herbs.

Drug treatment

Drug treatment is not advised during the first trimester. During this period, the laying of the main internal organs of the baby takes place. If there are small changes in the urine analyzes, you should adhere to the above tips. The approach to antibiotics is different; they are used in case of high temperature, when inflammation actively manifests itself. It is allowed to use penicillin for treatment.

In the second trimester, the type of antibiotics is more extensive, these are:

  • Furadonin;
  • cephalosporin II and III categories.

And also a group of macrolides:

  • azithromycin;
  • furadonin;
  • erythromycin.


Contraindicated for use during pregnancy:

  • Biseptol;
  • Tetracycline;
  • Levomycin;
  • Fluoroquinolone.

Pyelonephritis is a common ailment during pregnancy with complex consequences. But it is necessary to follow the doctor's instructions, even if it is frequent tests, repeated examination by a doctor, but this is for the good of you and your child.

Video on the topic of the article:

Due to the severe stress on the renal system, many women are treated for pyelonephritis during pregnancy. In most cases, this disease affects women between the ages of 18 and 30. Signs of pyelonephritis in pregnant women appear both in the first weeks of pregnancy and at a later date. The greatest risks of developing pathology are observed after the first three months of bearing a baby.

What types are there?

Inflammation of the kidneys in pregnant women is called pyelonephritis. Risks of occurrence for the first time such a disease greatly increases in pregnant women... Depending on the period of diagnosis of the disease, there are: primary gestosis pyelonephritis in a pregnant woman - when its manifestations were recorded for the first time; and secondary - when the disease has already been observed before pregnancy. There are 3 types of pyelonephritis:

  1. Gestational pyelonephritis in pregnant women is observed during gestation, even if there were no symptoms of the disease before. Its appearance is determined by the anatomical structure and functionality of body systems. This type does not depend on changes in the structure of urination. The reasons for the appearance of such deviations are: hypertension, cystitis, renal abnormalities, cystitis, diabetes, the present chronic form of pyelonephritis, etc.
  2. The acute form of pyelonephritis during pregnancy manifests itself in the form of purulent accumulations in the kidneys, a carbuncle or suppuration in the tissues of the organ. The prerequisites for the development of the disease are cystitis, abnormalities in the functioning of the renal system, the formation of sand and stones in the bladder and kidneys, and a violation of the bacterial balance.
  3. Chronic manifestations of pyelonephritis during pregnancy are due to the presence of inflammatory processes in the organs before the conception of the child. The disease proceeds in the form of alternating remission with periods of exacerbations - it has an undulating character. In this case, urgent therapy will be required in order to avoid the harmful consequences in the form of the overflow of the disease into another type - kidney failure.

Is it possible to get pregnant?


At the first sign of kidney disease, you should immediately go to the doctor's office.

Often women have a question, is it possible to get pregnant with pyelonephritis? The answer is ambiguous. That is, nothing will interfere with the process of fetal development. However, it should be understood that this disease is associated with many risks and deviations that affect the health of the unborn baby and his mother. If a pregnancy is planned, it is better to first undergo a course of treatment and prepare your body for bearing a fetus. In other cases, it would be reasonable to get expert advice, since it is necessary to assess the individual condition of the patient.

Causes of gestational pyelonephritis during pregnancy

During pregnancy, women greatly increase the content of estradiol, corticosteroids and progesterone in the blood. Such hormonal disruptions affect the bladder, reducing its muscle tone, weaken the functions of the renal system. The outflow of urine decreases - for this reason, urine is absorbed back - reflux occurs. Functional changes are aggravated by the pressure of the uterus, which has increased in volume, on the urinary tract. The process causes stagnation, which is a fertile ground for the emergence and development of pathogens. Gradually, the bacteria spreads to the kidney area, causing painful sensations.

Not all expectant mothers develop pyelonephritis. An important role here is played by immunity, hormonal levels, as well as the presence of prerequisites before pregnancy. The reasons are:

  • the presence of pathogenic bacteria in the body before conception;
  • hereditary abnormalities in the work of the kidneys;
  • reflux;
  • the presence of stones in the bladder;
  • chronic pathologies of the renal system.

In addition to the above factors, the development of the disease is influenced by the individual characteristics of the organism of the expectant mother and baby:

  • small size of the pelvis;
  • a large volume of amniotic fluid;
  • large fruit size or multiple fruits.

What are the symptoms?


Signs of an acute form of the disease are headaches, fever, nausea also develops, and a noticeable decrease in appetite occurs.

The first signs of pyelonephritis during pregnancy are most often observed in the second trimester. How strong the manifestations will be is determined by the form of pyelonephritis:

  1. The acute form of pyelonephritis is characterized by: increased body temperature, chills. Possible nausea and gag reflex, loss of appetite, muscle weakness and headaches, there is a rapid pulse, low back pain. The patient's condition will be lethargic. Pain from the base of the spine spreads to the abdomen and perineum. The painful sensations will intensify during physical exertion, lying on your side or on your back, as well as with deep breathing and the urge to cough.
  2. The chronic form is manifested by pain in the lumbar region, often they are aching, dull in nature. The patient will feel malaise and weakness, drowsiness and fatigue. Sometimes the manifestations are very similar to those of a miscarriage. If at least some of the possible manifestations were noticed in the expectant mother, it is necessary to inform the attending physician in order to take timely measures: to prevent pyelonephritis in the fetus and the woman in labor.

Risks in nursing and pregnant women

The appearance of inflammation in the kidneys during pregnancy is a dangerous and undesirable process. Acute gestational pyelonephritis leads to kidney failure and high blood pressure. There are three degrees of risk when pyelonephritis is dangerous during pregnancy:

  1. Grade I refers to the acute form of the disease, without unwanted complications, the development of which was caused by pregnancy. With the right treatment, severe consequences can be avoided.
  2. The II degree of risk includes women with chronic symptoms of the disease. Gestational pyelonephritis causes some complications in the condition of the expectant mother and can cause miscarriage. However, a normal course of pregnancy is possible if complications have been avoided.
  3. The III degree of risk includes patients with complications in the form of kidney failure during pregnancy and the presence of hypertension. The preservation of pregnancy is possible only with a stable and long-term remission and with the normal functioning of at least one of the organs. In any other case, bearing a fetus can be life-threatening.

What are the threats?

Early Influence

  • Since this pathology is characterized by inflammation that affects the kidneys, and is provoked by infectious bacteria, there is a danger of infection of the child in the womb in the early stages of pregnancy.
  • Exacerbation of pyelonephritis carries the risk of miscarriage.
  • Often the development of hypertension occurs, this contributes to the appearance of puffiness, which negatively affects the child.
  • Renal failure in acute form, as well as inflammation with the formation of suppuration (everything that requires urgent surgical action), are transmitted to the fetus.
  • Pyelonephritis often causes anemia, which leads to a lack of oxygen for the baby.

At a later date


Acute pyelonephritis is not an indication for termination of pregnancy.

Carrying a baby sometimes contributes to the development of inflammatory processes, after which gestational pyelonephritis during late pregnancy interferes with the normal bearing of the fetus:

  • the appearance of late toxicosis;
  • anemia;
  • termination of pregnancy due to infectious infections;
  • the patient may start giving birth prematurely;
  • severe complications of pyelonephritis on the vital organs of the child: eyes, lungs, liver, kidneys, etc.;
  • hypertrophy - weight loss, fetal developmental delays.

Complications of pyelonephritis

The possibility of complications increases with weak immunity and in the presence of diseases such as diabetes mellitus. If qualified assistance is provided in a timely manner, negative consequences can be prevented and the state of a healthy lifestyle can be maintained. Otherwise, complications are as follows:

  • the formation of a space in the kidney, which is filled with purulent masses - abscesses;
  • the development of renal failure;
  • The ingress of infected particles into the bloodstream and the appearance of sepsis.

Consequences for the child

The most dangerous fact is the transition of pathology from mother to child. If a child becomes infected with pathogenic bacteria in the womb, the consequences are very serious, up to the development of diseases of organs such as the heart, liver and kidneys, as well as a weakening of the immune system. Any illness that was transferred during gestation has consequences for the child. Consequences of gestational pyelonephritis for a nursing baby: hepatitis, low body temperature, emotional instability. Pathology causes oxygen starvation - this slows down the development of organs and systems of the body.

Diagnostics


Laboratory tests are recommended for pyelonephritis.

To get a reliable diagnosis, you need to go through a series of examinations. These include:

  1. Complete blood count - with pyelonephritis, the number of leukocytes increases, hemoglobin in the blood serum decreases.
  2. The concentration of creatine and urea - this is done using blood biochemistry.
  3. The urine is examined by general analyzes, for the content of protein compounds, leukocytes and bloody impurities in it.
  4. The bacterial composition of urine - to determine the causative agent of the infectious infection and its response to antibiotics.
  5. Ultrasound analysis to detect inflammation of the kidneys, their size, changes in the structure.
  6. Sometimes, a catheter is used to restore fluid flow. It is up to the doctor to decide if a catheter is needed.

So, pyelonephritis. Inflammatory kidney disease.

- It occurs quite often (urinary tract infections, according to statistics, rank second after ARVI in the structure of the incidence of infectious diseases)

- Prefers women (women get sick 8 times more often than men).

This is due to the anatomy of the female genitourinary organs: the short urethra is located next to the vagina, which makes it possible to quickly penetrate and spread the infection.

Men, on the other hand, suffer from pyelonephritis in old age, when prostate hypertrophy develops and urodynamics is significantly impaired.

- Among women, he especially "loves" pregnant women (pyelonephritis during pregnancy is 6-12% of the total morbidity).

Pyelonephritis and pregnancy often go hand in hand.

Pyelonephritis during pregnancy: causes

There are several causes of pyelonephritis that develops during pregnancy (“gestational pyelonephritis”).

1 Changes in the ureters: they lengthen, lose tone, they are compressed by the ovarian veins, dilated under the influence of hormones (the right ovarian vein suffers more often due to its anatomical location, respectively, during pregnancy, pyelonephritis of the right kidney often occurs, although bilateral lesions also occur) and a growing pregnant uterus (the process is aggravated by the presence of a narrow pelvis, a large fetus or multiple pregnancies).

2 Stagnation of urine and, as a result, the renal pelvis stretches up to hydronephrosis.

3 Reproduction of bacteria (especially Escherichia coli) against the background of reduced immunity, which often happens during pregnancy, under the influence of estrogens produced by the placenta.

With pyelonephritis, there is no specific pathogen. A variety of pathogenic flora is often sown: intestinal and Pseudomonas aeruginosa, Proteus, Klebsiella, enterococci, streptococci, staphylococci are less common. There are cases of detection of protozoa (Trichomonas), viruses, fungi, and sometimes microbial associations as a source of infection.

Infection of kidney tissue occurs in an ascending way. Through the blood, microbes can enter the kidneys from other foci of infection (for example, from the oral cavity with stomatitis, caries or ENT diseases).

Women who have had cystitis or pyelonephritis earlier are at risk.

Hypothermia, hypodynamia, hypovitaminosis also contribute to the development of pyelonephritis during pregnancy.

Features of the treatment of pyelonephritis during pregnancy

Treatment of pyelonephritis during pregnancy has several features.

First of all, you need to adhere to certain rules:

Eliminate hypothermia, nervous stress, heavy physical exertion, observe bed rest from the first days of treatment. Moreover, it is necessary to be treated in a hospital under the supervision of an obstetrician-gynecologist, therapist and, if necessary, a nephrologist to avoid complications. This is the so-called "positional treatment", which begins with a unilateral lesion. In order to restore the outflow of urine, you need to take a knee-elbow position on the side opposite the diseased kidney. The legs should be above the head end of the torso. Thus, the pressure of the uterus on the diseased ureter and kidney is reduced, and an improvement in the outflow of urine through the compressed ureter is provided. If the situation does not improve during the day, the issue of catheterization is considered.

Bed rest- a prerequisite from the first days of the disease, since the clinic is pronounced and accompanied by intense pain, high fever, chills, significant bacteriuria, urinary disorders, sometimes nausea and vomiting. Failure to comply with bed rest can lead to serious complications up to and including termination of pregnancy.

Prescribing medicines with pyelonephritis is a prerequisite for treatment. They start taking them from the first day to prevent complications.

Several groups of drugs are used: antibiotics, uro-antiseptics, antispasmodics, if necessary, painkillers and sedatives, depending on the severity of the condition and examination data.

There are some peculiarities of prescribing medications. Considering that pyelonephritis develops in the presence of pregnancy, the main requirement is not only effectiveness, but also safety for the fetus.

All treatment takes place individually, depending on the severity of the condition, the size of the clinic, the timing of pregnancy.

In the first trimester of pregnancy the formation of the fetus, the laying of organs occurs. The placenta has not yet formed and does not perform its protective functions. Antibiotics are prescribed during these periods only if absolutely necessary and with caution. You can use drugs of the penicillin group (Ampicillin, Oxacillin, Amoxicillin, Amoxiclav).

In the second trimester groups of drugs for treatment are expanding. Let’s take second and third generation cephalosporins (suprax, ceftriaxone, cefazolin), you can take furadonin. Reception restrictions - no later than the 36th week of pregnancy, the duration of treatment is from five to ten days.

From the fourth month of pregnancy if necessary, 5-NOK (nitroxoline) is prescribed.

The group of macrolides ("Sumamed"), erythromycin, is relatively safe, but they are active only against staphylococcus. Most of the causative agents of pyelonephritis are resistant to them.

There are categorical contraindications for certain drugs and drug groups at any stage of pregnancy. These include fluoroquinolones (nolicin, ciprofloxacin), tetracyclines, biseptol, and chloramphenicol. You need to know about this, and never self-medicate, since the risk of complications is very high. Even in a medical institution during hospitalization, drugs are prescribed exclusively after certain examinations (including bacterial sowing) in order to identify a specific pathogen and its sensitivity to a specific antibiotic.

Pyelonephritis during pregnancy: can it be treated with folk remedies

As an addition to the main treatment, which is carried out under the supervision of specialists in a hospital, you can use certain folk remedies. Herbal medicine comes into play. The purpose of this method of treatment is to improve the outflow of urine, reduce inflammation. This means that plants are used that have anti-inflammatory and diuretic (diuretic) effects.

But herbal treatment of pyelonephritis, which developed during pregnancy, also has a number of features. It is necessary to remember the list of herbs that are prohibited for use in pregnant women, but they successfully treat pyelonephritis, due to their various properties, outside of pregnancy. These include the well-known bearberry, juniper fruits, parsley, yarrow, licorice.

It would seem that such a harmless and affordable herbal treatment method also requires special care and knowledge. Self-medication is unacceptable.

One of the tasks of using folk remedies, as discussed above, is to increase the outflow of urine from the kidneys, that is, to "flush" them. To do this, it is necessary to take a sufficient amount of liquid (about two liters per day), provided that there is no edema. You can use a variety of teas with birch leaves, nettles, cranberry and lingonberry fruit drinks. It is safe for pregnant women and effectively complements drug treatment.

Oats are a unique treatment. Its possibilities are endless! But you need to use cereals, not flakes. A broth is prepared, filtered and taken several times a day on an empty stomach for one hundred milliliters (half a glass). The preparation of the broth is as follows: over low heat for two to three hours, you need to boil cereals in a 1: 1 ratio with water (a glass of oats per liter of water). At the same time, the volume of the liquid becomes two times less. You will have to stock up on time and patience, but the result is worth it!

Broth of oats has universal properties and the widest range of effects on many organs and systems. Pyelonephritis during pregnancy is a direct indication for its use: oats, unlike many other plants, reduces the hypotension of the ureters, does not increase the tone of the uterus. It has an anti-inflammatory effect, which is very important in treatment. And its main distinguishing feature is the formation of mucus, which improves stool and helps prevent constipation. This is invaluable during pregnancy, as many women who lead a sedentary lifestyle often suffer from this for various reasons. So oats can be considered a real find for the treatment of pyelonephritis during pregnancy!

Sometimes the general condition, well-being and mood are such that there is no desire to brew herbs on their own. There is an exit. There is a ready-made combination of herbs approved for use in pyelonephritis in pregnant women. This is the official drug "Kanefron". It is composed of centaury, lovage and rosemary. Due to the properties of these plants, it has anti-inflammatory, antimicrobial, antispasmodic and mild diuretic effects.

Thus, the treatment of pyelonephritis during pregnancy should be timely, in full and using all the necessary and available methods. Self-medication or inaction should not be allowed, since this threatens with numerous complications for both the pregnant woman and the fetus.

Pyelonephritis during pregnancy: prognosis for childbirth

The most common complications of pyelonephritis during pregnancy include late toxicosis, spontaneous abortion early or late, premature birth, fetal death, and the development of severe anemia.

In addition, a newborn baby can suffer from the infection. Pathology in a child. born of a mother suffering from pyelonephritis during pregnancy can be of varying severity. Conjunctivitis is common as the easiest complication. But serious damage to internal organs (lungs, kidneys, etc.) is not excluded.

It is important to know that during pregnancy with any infectious disease, including pyelonephritis, fetal hypoxia occurs. This leads to hypotrophy, underdevelopment of muscle mass. Such a newborn will often get sick, lag behind in general development.

In this regard, you need to take care of your health and monitor your well-being, given that pyelonephritis can be asymptomatic in some cases. And if you skip some of its signs, which are insignificantly expressed, and do not start treatment on time, the consequences will be sad.

That is why, during pregnancy, you need to lead the most active motor lifestyle, follow a certain diet that does not require much effort, but will reward in the end with a good result.

Pyelonephritis during pregnancy: prevention of complications, diet

First of all, you must refrain from salty, spicy and fried foods. This will prevent another unpleasant consequence of pyelonephritis during pregnancy, which develops quite often: arterial hypertension, eclampsia or preeclampsia of pregnant women.

And, of course, you cannot do without the traditional use of watermelon, melon, pumpkin, which should be consumed in large quantities, if possible. They have an excellent diuretic effect, and in themselves are ready-made medicinal products that improve the outflow of urine from the kidneys and prevent the development of edema.

In this case, it is necessary to urinate as often as possible - this helps to flush the kidneys and is another way to prevent urinary stagnation. And under any life circumstances, do not forget about walks, maximum physical activity, while avoiding hypothermia.

Take care of yourself and stay full of strength and health!

Pyelonephritis Is an inflammatory process that occurs as a result of the multiplication of infection in the kidneys. The most common causative agents of the disease are Escherichia coli, Staphylococcus, Enterococcus, Proteus.

Sometimes the doctor writes on the card instead of the diagnosis the disease code, which is taken from the International Classification of Diseases of the tenth revision.

ICD-10 code for gestational pyelonephritis:
O23.0 Kidney infection during pregnancy

What is gestational pyelonephritis?

Gestational it is called when pregnancy is the cause. During the entire period of gestation, the size of the uterus continuously increases, putting excessive pressure on the ureters (especially the right one), as a result of which the upper urinary tract (renal pelvis and ureters) expands.

The pathological process of expansion begins in the second half of gestation, reaching a peak in the first weeks of the third trimester, and ending soon after birth. Under the influence of pregnancy hormones (progesterone and hCG), in addition to the expansion of the renal pelvis and ureter, the motor ability of the urinary tract deteriorates, due to which the outflow of urine (urine) is impaired. Stagnant urine is a favorable environment for infection to enter and multiply in the urinary tract.

Ways of penetration of pathogenic microbes:

  • hematogenous pathway (due to bacteremia)... If there is a focus of infection in any part of the body, pathogenic bacteria enter the bloodstream. Through the blood, bacteria disperse throughout the body and, falling into suitable conditions, begin to multiply.
  • ascending path (urinary tract)... From an infected urethra or bladder (with urethritis, cystitis), pathogenic microorganisms move up the urinary system, affecting the renal pelvis. Thus, untreated cystitis can cause the development of this disease.

If there is a focus of infection in the vagina (for example, with vaginitis), after a while, bacteria are transferred from the vagina to the urethra, urethritis occurs, which can develop into pyelonephritis.

The risk of developing the disease increases if a woman has cystitis, asymptomatic bacteriuria, impaired urine outflow, or other problems with the urinary system before or during childbearing.

If you walk barefoot on a cold floor, sit on a cold floor or swim in cold water, you will get cold!

Detection of urea in the blood of more than 8.3 mmol / l indicates a malfunction of the organ.

High albumin levels may indicate the presence of chronic kidney disease.

5. Adopting the knee-elbow position for 15-20 minutes 3-5 times / day. This position helps to improve the outflow of urine with difficulty urinating.

Throughout the treatment, careful monitoring of the child's condition should be carried out for early detection of possible hypoxia and delay in its development.

With repeated pyelonephritis, a catheter is inserted into the ureter through the urethra to drain urine, and antibiotic therapy is prescribed.

Surgical intervention is necessary only if taking medications did not give the expected results or the inflammation was aggravated by a purulent process in combination with the destruction of kidney cells. In severe cases, due to the lack of proper treatment, the disease can cause renal failure, the development of a kidney abscess, and threaten a woman with death.

Qualified medical care will help to avoid negative consequences. If hospitalization is offered, one should not refuse!

After treatment, it is necessary to pass urine for general analysis once every 2 weeks until the end of gestation, and monthly for bacterial culture. The probability of a repeated exacerbation of the disease before childbirth is about 20%.

Disease prevention

A woman in a position must pass urine for analysis at every scheduled visit to a gynecologist, because the prevention of an ailment is reduced to the timely detection of asymptomatic bacteriuria.

Is it possible to avoid exacerbation of pyelonephritis during pregnancy? To prevent remission of the chronic form of the disease, urological phytopreparations, for example, Kanefron N, Brusniver collection, should be taken from the end of the first trimester, and exercises should be systematically performed to improve the functioning of the urinary system.

It is also important to observe the drinking regime, consuming a sufficient amount of clean water without gas (at least 1.5 l / day).

Childbirth with pyelonephritis

In acute pyelonephritis, caesarean is extremely undesirable, since an infection in the kidneys can aggravate the condition of the postpartum woman after childbirth. Delivery takes place naturally with the obligatory administration of antispasmodics to relieve renal pain.

A history of pyelonephritis is not an indication for a cesarean section, termination of pregnancy (except when a woman is at risk of losing her health or life).

The chronic form of the disease is often complicated by late toxicosis, which is why obstetricians are forced to carry out drug stimulation of labor, in emergency cases, even resort to caesarean section.

After discharge from the hospital, the patient is registered with a urologist (nephrologist).