During pregnancy, many women experience a disease such as gestational pyelonephritis. This pathology occurs due to the penetration of infection into the kidneys. The inflammatory process is accompanied by painful sensations. Few women seek medical help in a timely manner, fearing the harmful effects of drugs on the fetus. In fact, such neglect can negatively affect the baby.
General information
Pyelonephritis is an inflammatory process in the kidney that develops as a result of infection. Women in position have a greater predisposition to this disease due to poor urine outflow and pinching of the outlet canal by the growing uterus. Pyelonephritis is manifested by a sharp increase in temperature, painful discomfort in the lumbar region. Doctors usually recommend antibiotic therapy to fight the infection. With proper treatment, the expectant mother has every chance of giving birthhe althy baby.
How is gestational pyelonephritis different? During pregnancy, the uterus, which grows every day, presses on the surrounding organs. Very often the ureter itself is clamped. This is the channel through which urine flows from the kidney directly to the bladder. Slowing down the process provokes its stagnation and expansion of the kidney. This condition is typical for pregnancy. Sometimes through the bladder, the infection enters the kidney, and poor outflow of fluid favors this process.
If a future mother was diagnosed with chronic pyelonephritis before pregnancy, and now gestational pyelonephritis has developed, the risk of complications is quite high. Such women should be constantly monitored by a doctor and strictly follow all his prescriptions.
Classification of gestational pyelonephritis
The disease can manifest itself in any trimester of pregnancy, in parturient women this condition is diagnosed extremely rarely. Usually, pathology develops in the first half of the term. Many experts attribute this to the body's inability to quickly adapt to new conditions.
There are acute and chronic forms of this disease. Most often during pregnancy, the second variant of the pathology is observed, which can be detected by a characteristic change in the composition of urine. It is difficult to treat, and in some cases causes abortion.
Acute gestational pyelonephritis is manifested by severe intoxication of the body, but does not pose a threat to the life of the fetus inside the womb. In anycase, the treatment of this pathology should be approached with all seriousness. The disease at the 16-24th week of pregnancy, regardless of the form of the course, can cause a miscarriage.
Also, doctors distinguish between primary and secondary pyelonephritis. In the first case, the disease occurs against the background of complete well-being, that is, without any prerequisites from other organ systems. The secondary variant of the disease is characterized by the presence of a purulent focus, from which the pathogenic flora is carried not only into the kidneys, but also into the lungs and genitals of a woman. With a sharp deterioration in well-being, we can talk about the development of a septic condition.
Classification of the disease affects only the choice and tactics of therapeutic measures. Its pathogenesis remains the same in all cases.
Main causes of disease development
In a pregnant woman, around the end of the first trimester, the concentration of estradiol in the blood increases sharply, as well as the level of progesterone. Such hormonal changes affect the tone of the muscles of the bladder, calyces and renal pelvis. The flow of urine gradually slows down, refluxes appear. All these changes increase the pressure of the enlarged uterus on the urinary tract, congestion occurs. This pattern contributes to the penetration of pathogenic flora and its subsequent reproduction. Bacteria (streptococci, proteus, enterococci) gradually rise to the level of the kidneys and provoke their inflammation.
Gestational pyelonephritis during pregnancy is not always diagnosed. specialimportant: the state of the woman's immune system, individual hormonal differences. Experts identify a number of factors contributing to the development of this disease:
- Pre-pregnancy bacteriuria.
- Refluxes.
- Anomalies of the kidneys and bladder at the congenital level.
- Chronic ailments.
- Urolithiasis.
In addition, with some distinctive features of pregnancy (narrow pelvis, polyhydramnios, large fetus), the risk of developing pyelonephritis increases several times.
What symptoms indicate pathology?
- Many women often have no complaints, and pathological changes are detected during a laboratory examination (leukocytes and bacteria in the urine). When sowing, the rapid growth of Escherichia coli is usually determined, less often - staphylococcus aureus.
- Gestational pyelonephritis in pregnant women can be accompanied by severe pain in the lumbar region, the discomfort increases with prolonged stay on the legs.
- When exacerbation, the temperature rises.
- Frequent urination is typical of a normal pregnancy. In the case of pyelonephritis, the urge may be imperative, and urination itself may be painful.
- A frequent companion of the disease is high blood pressure.
- Swelling of the legs in women in position are considered normal. This is not always associated with the pathology of the urinary system. Such a symptom may indicate a violation of the venous outflow. Swelling in pyelonephritis usually increases, puffiness of the face occurs.
- Headspain, fatigue, a feeling of weakness in the morning - all these signs only complement the clinical picture.
How dangerous is pyelonephritis for a pregnant woman?
A disease such as gestational pyelonephritis, the symptoms of which we discussed above, automatically puts a pregnant lady at risk. Why? The inflammatory process in the body increases the load on the cardiovascular system and kidneys. 30% of women with this diagnosis develop preeclampsia (late toxicosis).
In this condition, blood circulation in the kidneys, brain, placenta noticeably deteriorates. The blood becomes thick, and the amount of oxygen in it decreases. All this is reflected in the nutrition of the fetus and the condition of the woman herself.
Among the main negative consequences of this disease, experts include the following:
- Threat interruption is the most common complication of gestational pyelonephritis.
- Premature birth.
- Multiple bleeding.
- Placental abruption.
- Anemia.
The appearance of this or that complication depends mainly on the severity of the inflammatory process and the timeliness of going to the doctor.
Gestational pyelonephritis during pregnancy: effects on the fetus
The inflammatory process in the kidneys often affects the baby in the womb. Chronic lack of oxygen and essential nutrients leads to fetal malnutrition. This means that the child appears onthe light is weak and with little weight. In about half of the cases, doctors note hypoxia. Premature babies are born in 30% of women with this diagnosis.
Other complications are common: fetal hypothermia, intrauterine infection, asphyxia with simultaneous CNS damage.
Disease diagnosis
The most important and informative test for this pathology is urinalysis. The presence of an inflammatory process is indicated by a large number of leukocytes, the presence of pathogenic microflora, the appearance of a protein.
There may also be signs of infection in the blood (growth of leukocytes and ESR). To identify the type of bacteria that provoked inflammation, the doctor conducts a urine culture for flora and sensitivity to certain antibiotics. Based on the results of this test, a specialist can prescribe a drug therapy that is suitable for a particular woman.
Also, diagnostics involves an ultrasound. The study usually reveals an expansion of the internal parts of the kidney and an increase in the size of the organ. The doctor must make sure that gestational pyelonephritis does not affect the condition of the baby inside the womb. For this, fetal ultrasound, CTG and dopplerometry are prescribed.
How to treat pyelonephritis in pregnant women?
If the expectant mother has noticed symptoms characteristic of inflammation of the kidneys, you should immediately seek help from a doctor. Timely diagnosis and high-quality treatment reduce the risk of abnormal fetal development, exclude the possibility of abortion.
First of all, women are recommended the so-called positional therapy. It is aimed at reducing compression of the ureters and accelerating the outflow of urine. Expectant mothers are not recommended to sleep on their backs, it is better to prefer the option on the left side. During the day, you should take the knee-elbow position and remain in this position for at least 10 minutes. At this time, you can read a book, work on a computer or play with an older child.
Therapy for gestational pyelonephritis also involves changing the drinking regimen. If there are no serious edema and high blood pressure, the amount of fluid consumed per day can be increased to two to three liters. It can be the most common non-carbonated water, compotes or jelly. It is better to give up strong tea and coffee for a while.
Many diuretic herbs during pregnancy are categorically contraindicated. It is forbidden to use bearberry, licorice, parsley. It is better to drink cranberry / lingonberry fruit drinks, brew birch leaves. A real find for many women in a position with such a diagnosis is a decoction of oats. This remedy does not increase the tone of the uterus, but has an anti-inflammatory effect and prevents constipation. To prepare it, you need to take a glass of cereal, pour a liter of water, boil over low heat for about two hours, and then strain. The decoction should be drunk three times a day before direct meals.
What medications can a doctor prescribe?
Therapy for gestational pyelonephritis includes antibacterial and anti-inflammatorytreatment. The use of many antibiotics and some uroseptics during pregnancy is categorically contraindicated, which greatly complicates the choice of drugs. In any case, the tactics of dealing with this disease is chosen by the doctor in the hospital, since all women with such a diagnosis are hospitalized without fail.
In the first trimester, the so-called barrier function of the placenta is usually not fully formed. At this time, an important stage in the laying of the main systems of the child's organs takes place, so the medicinal effect is undesirable. If changes are detected only in urine tests, most likely, it will be possible to confine oneself to the above recommendations. In case of active inflammation, which is accompanied by fever and pain, the use of penicillins (drugs "Amoxicillin", "Amoxiclav") is allowed.
From the second trimester it is allowed to take antibiotics of the cephalosporin group (Supraks, Cefazolin), macrolides (Vilprafen, Sumamed). From the fifth month (with an active inflammatory process), the remedy "Gentamicin" is used strictly according to the doctor's prescription.
Treatment of gestational pyelonephritis also involves detoxification therapy, the use of vitamin complexes and sedatives. Particular attention is paid to the prevention of fetal hypoxia. In case of urgent need, the urine flow is restored through catheterization and stenting of the ureter.
What should I change in my diet?
Special attention in the treatment of the disease is given to the diet of a pregnant woman. Doctors recommend avoidingspicy (spices, garlic, onions) and pickled foods (cucumbers, tomatoes, mushrooms). For some time, you will have to give up coffee, alcohol is completely prohibited.
To avoid water retention in the body, doctors advise reducing s alt intake. This recommendation primarily applies to women with high blood pressure.
The diet for gestational pyelonephritis is different in its vitamin nature. Women in position should eat more fruits and vegetables in their raw form, make juices from them. Sour-milk products (cottage cheese and low-fat sour cream) are considered a good choice. During recovery, the diet should be diversified with lean protein foods (these are sea fish, chicken breasts).
Prevention measures
To prevent the development of gestational pyelonephritis, it is extremely important for expectant mothers to include several items in their daily routine:
- Moderate physical activity. Doctors recommend taking small walks daily (about 1 hour).
- Special gymnastics for pregnant women. Today, many sports centers conduct classes for women in position, thanks to which the back muscles are strengthened and the tone of all internal organ systems improves.
- If you have a history of diseases of the urinary system, you must follow a special diet that promotes the outflow of urine.
- It is recommended to consume a large amount of fluid per day.
- Empty your bladder at least every three to four hours.
Attentive attitude to one's own he alth and prevention of gestational pyelonephritis is the key to the birth of a strong baby. Such an insidious disease should not be neglected. When primary symptoms appear, it is better to consult a doctor and take all necessary measures to eliminate the pathology. Stay he althy!
