Pyelonephritis in Pregnancy From the Lens of an Underserved Community

Chioma C Umeh1, Okelue E Okobi2, Olamide I Olawoye3

  • 1Family Medicine, Sure Hope Hospital, Lagos, NGA.

Cureus
|October 14, 2022
PubMed

Insights

Early detection of pyelonephritis in pregnancy is difficult due to overlapping symptoms and limited healthcare access in underserved populations. This case highlights challenges in resource-poor settings.

Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Public Health

Background:

  • Urinary tract infections (UTIs), including cystitis and pyelonephritis, present diagnostic challenges in pregnancy due to symptom overlap with gestation.
  • Resource-poor settings exacerbate these challenges due to factors like poverty, limited healthcare access, inadequate diagnostics, and cultural barriers.

Observation:

  • A case report details a 33-year-old G3P2 patient with pyelonephritis during pregnancy.
  • The case was complicated by significant barriers to accessing care within a resource-limited environment.

Findings:

  • Pyelonephritis in pregnancy is challenging to diagnose early, especially in underserved populations.
  • Access to healthcare, diagnostics, and education are critical obstacles in managing this condition in resource-limited settings.

Implications:

  • Improved healthcare access and diagnostic capabilities are crucial for managing pyelonephritis in pregnant individuals in underserved areas.
  • Understanding and addressing socioeconomic and cultural factors is essential for effective public health strategies in maternal care.

Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
37
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
32
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
24
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
71
Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
31
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
88