[Pyelonephritis and pregnancy. Our experience in a general hospital]

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.

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.

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.

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.