[Prevention of acute and recurrent pyelonephritis in pregnancy]

In recent years the morbidity of the acute gestational pyelonephritis increased nearly double. From the anamnesis of 234 female patients who were hospitalised on account of chronic pyelonephritis or urolithiasis in 34.9% renal complications during pregnancy could be established. In these cases a sixfold increased coincidence of the lateral localisation of urological disease compared with the lateral localisation of the obstetrical complications. From the catamnestic data of 32 patients resulted a pathogenetic connection between chronic urological disease and acute gestational pyelonephritis. Pregnant women with contracted pelvis, megafetus, multigravidity and hydramnion fell ill from acute pyelonephritis 4 to 6 times more frequently than those in whom these risk factors which we intend to call compression factors were not existing. 72 pregnant women with compression factors and asymptomatic bacteriuria were given prophylactically antibiotics and carried out position exercises. In none of these pregnant women an acute pyelonephritis appeared during pregnancy. Apart from the primary prevention of the acute gestational pyelonephritis in 108 pregnant women also a prophylaxis of the recidivation of pyelonephritis has been performed. This consisted of a therapy with antibiotics for the persisting, asymptomatic bacteriuria as well as position exercises. Only in 2.7% of the metaphylactically cared patients a recidivation of the acute gestational pyelonephritis developed. Thus incomparison to other authors the number of recidivations of acute gestational pyelonephritides could bei reduced by the four- to sixfold.