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

Introduction. Pyelonephritis is a common complication of pregnancy. It is also exacerbated by immunocompromised states and also the sickle cell gene. We reviewed this condition in Jamaican women. Method. We did a six year hospital database docket review. We found 102 confirmed cases. Results. Pyelonephritis was found in 0.7% of deliveries. The mean maternal age was 24 ± 5.83 years with 51% primiparity. Most (58.8%) occurred in the second trimester. The main symptoms were loin pain (96.2%) and abdominal pain (84.6%). It was more common on the right side in 67% of cases. On urinalysis, 81.4% had pyuria. The commonest organism was Escherichia coli, in 61% of cases. Patients given Antibiotics prior to admission had quicker resolution, P < 0.02. Haemoglobin S was found in 16% cases (general population 10%; P = 0.002). However diabetes was only found in 1.3% cases (1.5% expected). 61.3% had positive urine culture after treatment showed that 61.3% and 25% had recurrent pyelonephritis. Complications included 32% threatened preterm labour and 17% preterm delivery. About 6% of neonates had intrauterine growth restriction. There were no ICU admissions and no deaths. Conclusion. Early recognition and treatment of pyelonephritis result in good outcome. The condition is more prevalent in patients with the sickle cell gene and recurrence is high.