Acute Pyelonephritis – What Is It?
Acute pyelonephritis or better known as bacterial infection on the kidneys, usually affecting 1% to 2% of pregnant woman. In usual cases, the infection will first develops within the lower side of urinary tract. If left undetected and treated in timely manner, the infection could ascend to the urethra and also genital area towards the bladder, and then to the kidneys.
When compared to normal women, is more likely to be affected by pyelonephritis. Usually this is because of the physiological changes occurring during pregnancy stage that interfere the urine flow. The ureters normally drain the urine from kidneys and into the bladder, and then out of our body throughout the urethra. However, during pregnancy, there’s high concentration of progesterone hormone which can inhibit the contraction of these so-called drainage ducts. During pregnancy, the uterus will becomes enlarged and compresses the ureters. These unusual changes can usually lead to urine drainage problem from the kidneys, and thus causing urine in stagnant condition. As a direct result, bacteria within the bladder can migrate up towards the kidneys and then cause infection. (E. Coli) bacteria is the main culprit. Other bacteria such as Proteus species, klebsiella pneumoniae, and staphylococci can also causes kidney infection. Mormally around 75% to 80% of cases occur on the right kidney, and 10% to 15% are left-kidney, and usually around 10% are the bilateral.
Common Symptoms of Pyelonephritis?
Normally, the first pyelonephritis symptoms are inclusive of high fever, feeling the chills, and also suffer lower back pain on both side. The infection may also causes vomiting and feeling nausea. It is also common to have which includes:
- Higher frequency (the urge to urinate oftenly);
- The urgency (need to urinate urgently);
- dysuria (painful when urinating); and
- hematuria (some blood when urinating).
Proper medical treatment to treat pyelonephritis will prevent further serious problems. If condition get worse, infection will lead to sepsis which is infection of the bloodstream, this will spread to other body parts and cause more serious conditions that will require emergency treatment. If left untreated, pyelonephritis will lead to acute respiratory disorder when fluid accumulates in lung capacity. During pregnancy, Pyelonephritis is the leading cause of preterm delivery that will puts the baby in high risk of serious complications and may even lead to death.
Like other infections suffered during pregnancy stage, untreated pyelonephritis will lead to preterm labor, a leading cause for non fatal complications and also death in newborn baby.
A simple urine test can be done to determine whether the symptoms are due to kidney infection or not. Through examining the urine sample, your doctor usually can identify if the white blood cells or bacterium are present, both are the telltale . Usually with the presence of white blood cells, it means that the kidneys has been infected. Further diagnosis will be completed to further confirm bacteria cultures on the urine.
Touch wood… let say you develop pyelonephritis and you’re pregnant, you will need to be hospitalized and treated. You will normally be given with intravenous antibiotics, or probably on cephalosporin drug such as ceftriaxone (Rocephin) or cefazolin (Ancef). Once you’re on antibiotics, usually around 75% of the patients will improve within the 48 hours. And by the end of the 72 hours, almost around 95% of the patients will be cured or without fever nor other symptoms.
If your do not go away, it may be because that the microorganisms which is causing the infection is a bit more resistant to the antibiotic. Your doctor will need to give you gentamicin (Garamycin)-which is a stronger antibiotic to help your body fight it off.
Another main cause of failure to the treatment is obstruction in the urinary tract. Typically caused by kidney stone or possibly physical compression on the ureter when the uterus is growing uterus when pregnant. Obstruction of urinary tract can be confirmed with an x-ray diagnosis or ultrasound on your kidneys.
Once you start to improve and healthier, you are most likely be allowed to discharge from the hospital. Normally your doctor will also give you some oral antibiotics for the seven or 10 days. Specific oral agents will be selected based on the effectiveness, expense and toxicity. Nitrofurantoin monohydrate macrocrystals (or Macrobid) or trimethoprim-sulfamethoxazole (Septra, Bactrim) are normally dispensed to patients.
Approximately around 20% to 30% of pregnant women suffering with pyelonephritis will develop re-current infections at later stage in pregnancy. The best cost-effective method to lower the reoccurrence risk is to consume a single antibiotic dose daily for preventive measure.
You should have or ask the doctor to screen your urine for bacteria if you’re taking preventative medication each time you visit your doctor. Be sure to advise your doctor in case you notice any returning symptoms. If symptoms appear, or your urine screening result contains the presence of white blood cell or bacteria, then you will need to have another urine culture which to help determine if any treatment is required.