Acute pyelonephritis in pregnancy: a retrospective descriptive hospital based-study

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Nephrology

Background:

• Pyelonephritis is a significant pregnancy complication, worsened by immunocompromised states and the sickle cell gene.
• Understanding its prevalence and characteristics in specific populations, like Jamaican women, is crucial for effective management.

Purpose of the Study:

• To review the incidence, clinical presentation, and outcomes of pyelonephritis in pregnant Jamaican women.
• To identify risk factors and complications associated with this condition in the study population.

Main Methods:

• A six-year retrospective review of a hospital database.
• Analysis of 102 confirmed cases of pyelonephritis during pregnancy.

Main Results:

• Pyelonephritis occurred in 0.7% of deliveries, with a mean maternal age of 24 years, predominantly in the second trimester.
• Escherichia coli was the most common pathogen (61%). Patients receiving pre-admission antibiotics showed faster resolution (P < 0.02).
• Prevalence was higher in women with sickle cell trait (16% vs. 10% general population, P = 0.002). Recurrence was high (61.3%), with complications including threatened preterm labor (32%) and preterm delivery (17%).

Conclusions:

• Early recognition and prompt antibiotic treatment of pyelonephritis in pregnancy lead to favorable outcomes.
• The condition is more prevalent in women with sickle cell trait, and recurrence rates are substantial, necessitating vigilant monitoring and management.