Pyelonephritis in Pregnancy: Relationship of Fever and Maternal Morbidity

Document Type : Original Article

Authors

1 Obstetrics and gynecology faculty of medicine Bani suief university Bani suief Egypt

2 Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Egypt

3 Internal medicine & Nephrology, Internal medicine department, Beni- Suef University

4 Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-Suef University, Egypt

Abstract

Background: Acute pyelonephritis (pyelonephritis or Kidney infection) is accompanied with substantial morbidities for mother and fetus with complications involving preterm labor, preterm delivery, acute renal failures, acute respiratory distress syndromes (ARDS), sepsis, and mother or fetus mortality, in this study; we aimed to assess the association amid maternal fever at the hospitalization admissions and succeeding maternal morbidities in gravid cases with pyelonephritis.
Methods: The current study is a multi-center prospective study. Carried out at obstetrics and gynecology departments of Beni suef University hospitals, Al wasti city hospital and Nasser general hospital in the period between (2019-2021). Cases were allocated into 2 groups, those with and with no fever at the admitting time. Statistical analysis was used to assess the correlation of fever at presentation time with following morbidities. By admission significant symptoms, maternal early warning criteria (MEWC) have been employed and odds ratios estimated to expect intensive care unit (ICU) admissions.
Results: A number of 106 cases have been involved with pyelonephritis in gestation; 50-cases were febrile and 56-cases were nonfebrile on admitting, a high Statistical significance change was found between studied groups as regard Temperature, Heart rate, Respiratory rate and Days in hospital.
Conclusion: Pyelonephritis is accompanied with substantial morbidities for mother and fetus and earlier recognition of those cases at risk can cause improvement in the outcome. Cases with nonfebrile at admittance time are continue at risk of substantial morbidities with comparable admittance rate of ICU, ARDS, pulmonary edema, and preterm birth as febrile cases. Consequently, in cases with clinically signs and urinalysis results indicative of pyelonephritis, even in the nonappearance of fever.

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