Pielonefritis y embarazo. Experiencia durante un año en un hospital general / Pyelonephritis and pregnancy. Our experience in a general hospital

Objetivos: La incidencia de la pielonefritis durante el embarazo alcanza hasta un 2%. Para prevenirla recomendamos realizar análisis de orina en el primer trimestre con el objeto de detectar bacteriuria asintomática, debiéndose tratar aquellos casos con urocultivo positivo. Métodos: Se recogen de forma retrospectiva todos los casos diagnosticados de pielonefritis aguda en embarazadas ingresadas en nuestro Centro a lo largo del año 2004 y se tabulan los datos demográficos, métodos diagnósticos, tratamientos, evolución, nuevos episodios y repercusiones sobre la fecha del parto y del recién nacido. Resultados: Estudiamos todos los casos de pielonefritis en embarazadas ocurridas en nuestro centro durante un año (4.700 partos). Objetivamos que el despistaje de bacteriuria se hacía, de manera incorrecta con sedimento urinario (piuria). La incidencia fue de 0,21%, atribuyendo dicha cifra tan baja a que, posiblemente, alguna enferma con pielonefritisno ingresó en nuestro centro. Las evoluciones fueron favorables, siendo el único germen aislado E. coli. Las pielonefritis del primer trimestre recidivaron. Conclusiones: En todos los embarazos se debe realizar urocultivo en el primer trimestre debiendo, después del tratamiento adecuado, repetir el urocultivo, sobre todo si la bacteriuria ocurre en el primer trimestre de embarazo (AU)

Objective: The incidence of pyelonephritis during pregnancy reaches 2%. We recommend obtaining a urinalysis during the first trimester in order to detect asymptomatic bacteriuria and treat those cases with positive urine culture. Methods: We retrospectively reviewed all cases diagnosed as acute pyelonephritis in pregnant women admitted to our hospital during 2004 and analyzed demographic data, diagnostic methods, treatments, outcome, new episodes and the impact on the date of birth and the newborns. Results: We studied all the cases of pyelonephritis in pregnant women diagnosed in our hospital for one year (4,700 childbirths). We found that screening of bacteriuria was done incorrectly based on the presence of pyuria in the sediment of urine specimen. The incidence was 0.21 %, and such a low rate might be related to the possibility that some patients were not admitted in our hospital. Prognosis was excellent being E. coli the only agent isolated in all cases. Pyelonephritis that occurred during the first trimester relapsed. Conclusions: A urine culture must be obtained during the first trimester of pregnancy and should be repeated after completion of adequate therapy of an infection, particularly if bacteriuria is detected in the first trimester (AU)

[Pyelonephritis and pregnancy. Our experience in a general hospital]. / Pielonefritis y embarazo. Experiencia durante un año en un hospital general.

OBJECTIVE: The incidence of pyelonephritis during pregnancy reaches 2%. We recommend obtaining a urinalysis during the first trimester in order to detect asymptomatic bacteriuria and treat those cases with positive urine culture. METHODS: We retrospectively reviewed all cases diagnosed as acute pyelonephritis in pregnant women admitted to our hospital during 2004 and analyzed demographic data, diagnostic methods, treatments, outcome, new episodes and the impact on the date of birth and the newborn. RESULTS: We studied all the cases of pyelonephritis in pregnant women diagnosed in our hospital for one year (4,700 childbirths). We found that screening of bacteriuria was done incorrectly based on the presence of pyuria in the sediment of urine specimen. The incidence was 0.21 %, and such a low rate might be related to the possibility that some patients were not admitted in our hospital. Prognosis was excellent being E. coli the only agent isolated in all cases. Pyelonephritis that occurred during the first trimester relapsed. CONCLUSIONS: A urine culture must be obtained during the first trimester of pregnancy and should be repeated after completion of adequate therapy of an infection, particularly if bacteriuria is detected in the first trimester.