The following risk categories for the use of drugs during pregnancy, developed by the American Food and Drug Administration (FDA), are widely used throughout the world:
A- as a result of adequate, strictly controlled studies, no risk of adverse effects on the fetus was identified in the first trimester of pregnancy (and there is no data indicating a similar risk in subsequent trimesters).
B- animal reproduction studies have not revealed a risk of adverse effects on the fetus, and adequate and strictly controlled studies have not been conducted in pregnant women.
C- animal reproduction studies have revealed adverse effects on the fetus, and adequate and strictly controlled studies have not been conducted in pregnant women, however, the potential benefits associated with the use of drugs in pregnant women may justify its use, despite the possible risks.
D- there is evidence of the risk of adverse effects of the drug on the human fetus, obtained during research or in practice, however, the potential benefits associated with the use of the drug in pregnant women may justify its use despite the possible risk.

Treatment of asymptomatic bacteriuria in early pregnancy can reduce the risk of developing acute pyelonephritis in later pregnancy from 28% to less than 3% (9). Considering that pregnancy is a risk factor for the development of complicated infections, the use of short courses of antimicrobial therapy for the treatment of asymptomatic bacteriuria and acute cystitis is ineffective. An exception is fosfomycin trometamol (Monural) in a standard dosage of 3 g once, since in concentrations close to the average and maximum level, Monural leads to the death of all pathogens that cause acute cystitis within 5 hours, the activity of Monural against E. coli exceeds the activity of norfloxacin and co-trimoxazole (4). In addition, the concentration of the drug in urine in doses exceeding the MIC is maintained for 24-80 hours.

Fosfomycin trometamol is an ideal first-line drug in the treatment of acute cystitis in pregnancy. It has the necessary spectrum of antimicrobial activity, minimal resistance of primary uropathogens, resistant clones of microbes are damaged. It overcomes acquired resistance to antibacterial drugs of other groups and has bactericidal activity. According to Zinner, when using fosfomycin trometamol (n=153) 3g once, the cure rate for asymptomatic bacteriuria after 1 month was 93%.

Thus, for the treatment of lower urinary tract infections and asymptomatic bacteriuria in pregnant women, the use of monodose therapy is indicated - fosfomycin trometamol at a dose of 3 g; cephalosporins for 3 days - cefuroxime axetil 250-500 mg 2-3 times / day, aminopenicillins / BLI for 7-10 days (amoxicillin / clavulanate 375-625 mg 2-3 times / day; nitrofurans - nitrofurantoin 100 mg 4 times / day - 7 days (2nd trimester only).

In Russia, a study was conducted on the use of various drugs for the treatment of uncomplicated lower urinary tract infections in pregnant women, the data is presented in Table 4. At the same time, the frequency of incorrect prescriptions was 48%!!!

Table 4. Antibacterial therapy for infections of the lower parts of the bladder in pregnant women in Russia (Chilova R.A., 2006)

Table 5 presents the main adverse events when a number of drugs are prescribed during pregnancy.

Table 5. Risk of using medications during pregnancy

When identifying atypical pathogens (urea-mycoplasma infection, chlamydial infection) in patients with frequently recurrent cystitis, the use of macrolides (josamycin, azithromycin in standard dosages) in the trimester of pregnancy is indicated.

Emergency hospitalization is indicated for patients with acute pyelonephritis. The complex of laboratory diagnostic methods must include: general analysis of urine, blood, bacteriological examination of urine; Ultrasound of the kidneys and bladder. Monitor vital functions. The cornerstone of treatment for patients with gestational pyelonephritis is to resolve the issue of the need for drainage of the urinary tract and the choice of drainage method.

The indication for drainage of the urinary tract during pregnancy is the presence of acute pyelonephritis in the patient against the background of impaired urodynamics.

The choice of method of drainage of the urinary tract during pregnancy depends on: the causes of urodynamic disturbances (urinary tract disease, decreased tone of the urinary tract, compression by the uterus, reflux); timing of pregnancy; stages of pyelonephritis (serous, purulent).

In Table 6 we present methods of drainage of the urinary tract depending on the stage of pyelonephritis.

Table 6. Methods of drainage of the urinary tract during pregnancy with acute pyelonephritis (5)

Antibacterial therapy is carried out only parenterally, followed by monitoring the effectiveness of treatment after 48-72 hours. Subsequently, correction of antibacterial therapy is carried out based on the results of bacteriological examination. The duration of therapy for the serous stage of inflammation is 14 days: 5 days - parenterally, then switch to the oral regimen. Drugs approved for use in pregnant women for the treatment of acute pyelonephritis include:

A similar study of the use of antimicrobial drugs was conducted regarding the treatment of patients with acute pyelonephritis during pregnancy and found that the frequency of incorrect prescriptions of antibacterial drugs was 78%. The data is presented in Table 7.

Table 7. Antibacterial therapy for pyelonephritis in pregnant women in Russia (Chilova R.A., 2006)

In Russia, a high level of resistance of Escherichia coli to ampicillin, amoxicillin and co-trimoxazole has been identified, and therefore it is not advisable to use these drugs. Data on the level of resistance of Escherichia coli in Russia are presented in Table 8.

Table 8. Resistance of E.coli isolated from patients with outpatient UTIs in Russia to oral antibiotics, % Rafalsky V.V., 2005

Table 9. Grading system for evaluating recommendations in clinical practice guidelines proposed by the Infectious Diseases Society of America and the US Public Health Service

Currently, infectious diseases of the genitourinary system in women are characterized by polyetiology, a blurred clinical picture, a high frequency of mixed infections and a tendency to recur, which requires an integrated approach to diagnosis and treatment. The solution to the problem of antibacterial therapy in obstetrics and gynecology can be facilitated by: the creation of state standards and their strict compliance; creation of an expert council to revise standards; physicians' awareness of the principles of evidence-based medicine (1).

Learn more about the causes, symptoms and treatment of infectious diseases in expectant mothers.

About 10 percent of pregnant women, at one stage or another during pregnancy, experience urinary tract infections. The good news is that while this infection is very easy to catch, it is also easy to treat with antibiotics. However, we are talking about early treatment of diseases; if the disease is advanced, it will be more difficult to get rid of the annoying infection.

If left untreated, about 25% of asymptomatic urinary tract infections lead to kidney infection, a condition that is life-threatening for both the baby and the mother. That is why, throughout pregnancy, it is so important to take urine tests so that your obstetrician-gynecologist can identify such a dangerous enemy in time.

What are urinary tract infections (UTIs)?

The urinary system consists of the urethra, bladder, ureters and kidneys. An infection occurs when bacteria enters the system and begins to multiply. Most UTIs are bladder infections and are not dangerous if treated promptly.

If an infection in the bladder is not eliminated, it can travel higher to the kidneys and cause serious complications, such as premature birth, sepsis, or the birth of a baby with a significantly lower weight.

Let's name a few of the most common urinary tract infections:

• cystitis (complicated and uncomplicated),
• pyelonephritis,
• urethritis,
• bacteriuria.

What causes UTIs during pregnancy?

In most cases, sex is to blame. It is during love games and sex itself that bacteria enter the urethra from the vagina or anus. A busy sex life can lead to inflammation of the bladder, which makes it easier for bacteria to “colonize” it.

Among the causes of UTIs, irregular urination has also been noted, since urination effectively removes microbes from the urethra and bladder, as well as chronic diseases such as diabetes or neutropenia, for example.

Pregnancy does not cause UTIs, but the physical changes a pregnant woman's body undergoes make you more vulnerable to infections. For starters, the hormonal changes that occur during pregnancy create an ideal environment for the bacteria that are associated with UTIs (usually Escherichia coli, known as E. coli). Increased levels of progesterone relax the muscles of the urinary system, so bacteria can easily rise up the bladder and enter the kidneys faster than in non-pregnant women. An enlarged uterus makes it difficult to empty the bladder completely, resulting in favorable conditions for the proliferation of microbes. It is the enlargement of the uterus that most often leads to the occurrence of pyelonephritis in pregnant women (inflammation of the renal pelvis) - the most dangerous urinary tract infection.

What are the symptoms of UTI?

Some UTIs are completely asymptomatic; this course of infection is called asymptomatic. Typically, your obstetrician-gynecologist will periodically test your urine to detect UTIs.

Common symptoms of UTI include:

• sudden urge to urinate
• painful sensations, burning sensations during urination,
• urine with an unpleasant odor or cloudy sediment in it,
• urine with blood,
• pain in the groin.

Treatment

The good news is that UTIs are easy to treat. Your obstetrician-gynecologist will select the appropriate antibiotics based on your current condition. The choice of antibiotics will also take into account the duration of pregnancy and the presence of allergies. Most often pregnant women are prescribed drugs such as fosfomycin trometamol, amoxicillin or nitrofurantoin for 7-14 days, depending on the complexity of the case.

Preventing urinary tract infections

There are no methods that would 100 percent help prevent the occurrence of such infections during pregnancy. To reduce the risk of such occurrences:

• Proper hygiene - remember to use sanitary napkins after every urination to prevent the spread of bacteria.
• Drink enough fluids - timely urination will help eliminate germs in the bladder and urethra.
• Empty your bladder promptly and completely - don’t rush when going to the toilet, make sure you “eliminate” all the urine
• watch your diet - caffeine and chocolate are substances that can lead to bladder irritation and inflammation, and therefore it will be much easier for bacteria to stay in it for a long time
• Drink cranberry juice - this berry helps prevent the appearance of E. Coli in the bladder. Talk to your obstetrician/gynecologist about taking special cranberry capsules or pills.

The most common inflammatory diseases of the urinary system include asymptomatic bacteriuria (detection of a significant amount of bacteria in the urine), cystitis (inflammation of the mucous membrane of the bladder) and pyelonephritis - an infectious-inflammatory process accompanied by damage to the kidney tissue and the collecting system.

Asymptomatic bacteriuria

The diagnosis of “asymptomatic bacteriuria” is established when 100,000 microbial cells are detected in 1 milliliter of urine and there are no symptoms of urinary tract infection. Pregnant women with asymptomatic bacteriuria should be carefully examined to identify hidden forms of urinary system disease. First of all, laboratory research methods are used - blood and urine tests. Pathological changes are observed in a quantitative study of urine sediment (urine analysis using the Nechiporenko method), as well as in studies of the excretory and filtration capacity of the kidneys (urine analysis according to Zemnitsky, Reberg). Kidney ultrasound has become an integral part of the diagnostic package. Against the background of asymptomatic bacteriuria, acute pyelonephritis develops in approximately 30%-40% of cases, so such pregnant women need timely preventive treatment. The effectiveness of treatment is monitored by culture of urine for flora: the urine is placed on a special nutrient medium and it is observed whether colonies of microorganisms grow on the nutrient medium.

Cystitis in pregnant women

Cystitis accompanies a variety of pathological conditions of the urinary tract and genital organs. It may be the first manifestation of pyelonephritis or other urological diseases.

Acute cystitis is characterized by decreased ability to work, weakness, fever up to 37.5°C and local symptoms that allow one to suspect and, in many cases, make an accurate diagnosis. These include: painful urination (pain at the end of urination), pain in the suprapubic region, increasing with palpation and filling of the bladder, frequent urination (every 30 - 60 minutes).

The diagnosis must be confirmed by laboratory data: in case of illness, a urine test reveals leukocyturia (the presence of a large number of leukocytes), bacteriuria (the presence of bacteria). Pathological changes can also be observed in blood tests. Acute cystitis lasts 7-10 days; if it drags on, the doctor will prescribe an examination necessary to exclude inflammatory damage to the kidneys. Cystitis is treated with tableted antibacterial agents (semi-synthetic penicillins, cephalosporins) for 5-7 days. Timely recognition and treatment of asymptomatic bacteriuria and cystitis during pregnancy leads to a significant reduction in the risk of acute pyelonephritis and its immediate consequences for both the mother and the fetus (most often this is the threat of miscarriage or premature birth).

There are three degrees of risk of pregnancy and childbirth in women with pyelonephritis:

I degree - uncomplicated course of pyelonephritis that occurred during pregnancy;

II degree - chronic pyelonephritis, developing before pregnancy;

III degree - pyelonephritis, occurring with arterial hypertension (increased blood pressure), pyelonephritis of a single kidney.

The most severe complications occur with risk degree III, so women with pyelonephritis should be observed not only by an obstetrician-gynecologist, but by a general practitioner and a nephrologist. The outcome of pregnancy and childbirth depends not only on the degree of risk, but also on the duration of the disease, the degree of kidney damage and the general condition of the mother’s body.

Pyelonephritis in pregnant women

Pyelonephritis that occurs for the first time during pregnancy is called “gestational pyelonephritis” or “pyelonephritis of pregnant women.” It occurs in 6-7% of expectant mothers, more often in the second half of pregnancy. Pyelonephritis existing before pregnancy can worsen against its background or occur in a chronic and erased form. Women with pyelonephritis are at high risk for pregnancy complications such as miscarriage, preeclampsia2, intrauterine infection and malnutrition (stunted growth) of the fetus. The most dangerous complication is acute renal failure - a condition in which the kidneys completely or partially stop functioning.

Predisposing factors for the development of acute gestational pyelonephritis and exacerbation of chronic pyelonephritis during pregnancy are changes in the urinary system. Namely: urinary disturbances (caused by an increase in the size of the uterus), changes in hormonal and immune status, as well as the presence of recurrent (aggravated) cystitis before pregnancy, malformations of the kidneys and urinary tract (doubling of the kidney, ureter), urolithiasis, diabetes mellitus, etc. d.

To assess the clinical picture of an infectious kidney disease, and especially to select a treatment method, identifying the pathogen is of great importance. The close anatomical proximity of the urethra, vagina, rectum, and a decrease in antimicrobial immunity during pregnancy contribute to the colonization of the entrance to the urethra by bacteria from the intestine. A short urethra and close location of the bladder, impaired movement of urine along the urinary tract contribute to the upward spread of infection. This, apparently, explains the significant predominance of E. coli and other microbes that live in the intestines among the causative agents of urinary system diseases, which take first place during pregnancy. In addition, pregnant women often have yeast-like fungi of the genus Candida (thrush), mycoplasma and ureaplasma in their urine. The infection can also spread hematogenously (through the blood) from the source of inflammation - pharyngeal tonsils, teeth, genitals, gall bladder.

Most often, acute pyelonephritis occurs at 22-28 weeks of pregnancy (as well as at certain stages of pregnancy: 12-15 weeks, 32-34 weeks, 39-40 weeks) or on the 2-5th day of the postpartum period (these periods are associated with the characteristics of hormonal levels and increased functional load on the kidneys, later periods - with worsening urine outflow).

During the acute period of the disease, pregnant women complain of a sudden deterioration in health, weakness, headache, increased body temperature (38-40°C), chills, lower back pain, dysuric disorders - frequent urination, pain when urinating. We must remember that against the background of the underlying disease, signs of a threatening and incipient miscarriage or premature birth (due to the presence of an infectious process) may appear.

Pyelonephritis can begin early and initially be latent (in this case, the symptoms of the disease are not pronounced), therefore, to identify it, the entire range of diagnostic tests should be used with mandatory urine culture in all pregnant women.

Diagnosis of pyelonephritis is based on the above clinical signs, supported by laboratory data. It is important to study the average portions of morning urine and counting the number of formed elements in the urine sediment (leukocytes, erythrocytes, various casts - a kind of casts of the renal tubules and epithelial cells). Nechiporenko’s methods are used to calculate the ratio of leukocytes and erythrocytes (normally, in a pregnant woman, the ratio of leukocytes to erythrocytes is 2:1, i.e. 1 milliliter of urine contains 4000 leukocytes and 2000 erythrocytes) and Zemnitsky to determine the relative density and disturbances in the ratio of daytime and nighttime diuresis . All pregnant women with kidney pathology undergo a urine culture to identify microflora and determine its sensitivity to antibiotics, a general and biochemical blood test, as well as an ultrasound examination of the kidneys to identify the condition of the pyelocaliceal system. If pyelonephritis is suspected, the pregnant woman is hospitalized in the antenatal department of the maternity hospital, and long-term treatment is recommended (at least 4 - 6 weeks).

Treatment of pyelonephritis in pregnant women is carried out according to the general principles of therapy of the inflammatory process. The first stage of complex treatment consists of positional therapy. This is the position of the pregnant woman on the side opposite to the localization of pyelonephritis (on the “healthy” side), which promotes better urine outflow and speeds up recovery. The same purpose is served by the knee-elbow position, which a woman should periodically take for 10-15 minutes several times a day.

Antibacterial drugs are prescribed depending on the type of pathogen and its sensitivity to antibiotics. In this case, preference is given to drugs that do not have a pronounced negative effect on the condition of the fetus (very important) - semisynthetic penicillins, cephalosporins. To enhance the effect of therapy, antibiotics are combined with uroantiseptics (5-NOK, FURAGIN, NEVIGRA-MON).

An important point in the treatment of pyelonephritis is to improve the outflow of urine. For this purpose, antispasmodics and herbal diuretics are prescribed, which can be purchased in ready-made forms at the pharmacy or prepared yourself. The treatment regimen also includes vitamin complexes. If there are symptoms of intoxication (fever, weakness, weakness), infusion detoxification therapy is carried out (various solutions are administered intravenously - GEMODEZ, REOPO-LIGLUKIN, ALBUMIN).

With chronic pyelonephritis, without exacerbation, there is dull pain in the lower back, the urine contains a small amount of protein, and a slightly increased number of leukocytes. During pregnancy, the disease can worsen - sometimes twice or three times. With each exacerbation, the woman should be hospitalized. Treatment of exacerbation of chronic pyelonephritis is not much different from therapy for acute disease. During pregnancy, an appropriate diet is recommended with limited consumption of spicy, salty foods, drinking plenty of fluids, vitamin therapy, herbal uroseptics, and antibacterial drugs.

I would like to especially note that in parallel with the treatment of pyelonephritis, it is necessary to carry out complex therapy aimed at maintaining pregnancy and improving the condition of the fetus. Delivery is carried out through the natural birth canal, since cesarean section in conditions of an infected organism is extremely undesirable and is performed according to strictly obstetric indications.

It is worth mentioning the prevention of pyelonephritis. Due to the fact that 30-40% of pregnant women with asymptomatic bacteriuria develop an acute urinary tract infection, timely detection and treatment of bacteriuria is necessary.

And in conclusion, I would like to draw your attention to two main points regarding the postpartum period. Children born to mothers with pyelonephritis constitute a risk group for the development of purulent-septic diseases; and as for mothers, as a rule, after gestational pyelonephritis, kidney function is restored in most women.

We heal with herbs

It is known that medicinal plants have diuretic, antibacterial and anti-inflammatory effects. In the phase of active inflammation with pyelonephritis, the following collection can be recommended: sage (leaves) - 1 dessert spoon, bearberry (leaves) - 2 teaspoons, horsetail (herb) - 1 teaspoon, chamomile (flowers) - 2 teaspoons. All these herbs must be mixed and infused for 30 minutes in 400 milliliters of boiled water, then be sure to strain. The infusion should be taken hot, 100 milliliters 3 times a day before meals, in courses of 2 months with two-week breaks. During the period of remission, collections of medicinal plants with a pronounced effect on the regeneration process can be recommended. For example: dandelion (root) - 1 teaspoon, birch (buds) - 1 teaspoon, chamomile (flowers) - 1 teaspoon, nettle (leaves) - 1 teaspoon, lingonberry (leaves) - 2 teaspoons. Mix everything, leave for 30 minutes in 350 milliliters of boiling water, strain. It is recommended to drink the infusion hot, 100 milliliters 3 times a day, half an hour before meals for 2 months with a two-week break.

The kidneys can be divided into two parts - the medulla (the part where urine is formed) and the collecting system, which removes urine. With pyelonephritis, the latter is affected.

Preeclampsia is a complication of the second half of pregnancy, in which spasm of the blood vessels of the mother and fetus occurs, and both the pregnant woman and the baby suffer. More often, gestosis is manifested by increased blood pressure, the appearance of protein in the urine and edema.

The reproductive system is very closely related to the kidneys, for this reason they are combined into the genitourinary system. It often happens that they have the same infections.

Types of infections

The resulting kidney infection can be specific or nonspecific:

• A specific infection in the kidneys is associated with pathogens that are sexually transmitted (gonococcus, trichomonas, ureaplasma). The cause of the disease is clear. This is unprotected sex. In men, the infection immediately enters the urethra, and from there to the overlying areas of the genitourinary system. In women, the infection from the vagina enters the urethra and then moves along the same path of the genitourinary system. Infections must be treated, as quite dangerous complications are possible.
• Nonspecific. Such infections include staphylococcus, E. coli, streptococcus, enterococcus, candidal fungus and others.

A kidney infection can spread in several ways:

• The ascending route is from the urethra and rectum during sexual intercourse.
• Descending - passes from the renal pelvis down the ureters.
• Hematogenous route - brought by blood flow from other areas.

Escherichia coli is a common causative agent of kidney infections.

Causes

When an infection enters the human body, the kidneys are the first to suffer as they try to expel it.

A weakened body cannot always cope with such a problem, so the kidneys become infected and require adequate treatment.

The most common causes of kidney infections are:

• Urolithiasis disease.
• Anemia.
• Penetration through the circulatory system.
• Diabetes.
• Low immunity.
• Inflammatory processes in other organs.

Also, kidney damage may be associated with diseases of the gastrointestinal tract and uterus. Even dental caries can cause infection. This also includes hypothermia of the body and incorrect treatment of colds.

Symptoms of a kidney infection

The presence of infectious inflammation in the kidneys can be determined by the following signs:

• General malaise.
• Pain in the lower back, abdomen and groin.
• Temperature increase.
• Frequent urination.
• Little urine is excreted, it does not come out completely.
• Nausea.
• Loss of appetite.
• Itchy and sometimes sharp pain when urinating.
• Swelling of the face.
• The color and smell of urine changes.
• Presence.

Lower back pain is a common accompaniment of kidney infection

The most common diseases:

• Pyelonephritis is an inflammatory process in the kidneys as a result of the penetration of microorganisms. In addition, other pathologies are associated (for example, reduced immunity, kidney stones, hypothermia, inflammation in the adrenal glands and other ailments).
• Glomerulonephritis– an inflammatory process of the renal glomeruli, which develops against the background of an infectious allergy or due to the production of antibodies to one’s own organ. The spread is most often observed in children and young adults (under 30 years of age).

In infants, infections in the kidneys are more complicated and, due to weak immunity, are treated much worse. For this reason, it is necessary to consult a doctor when the first signs appear. The first symptoms will be changes in the color of urine and an increase in temperature. In addition, the child becomes capricious, sleeps poorly, refuses to eat, and does not gain weight.

During pregnancy, kidney and urinary tract infections are quite common. Since the enlarged uterus compresses the organs of the genitourinary system, thereby creating good conditions for the occurrence of pyelonephritis. Its signs are more pronounced in a pregnant woman, and complications are observed more often. Therefore, in order to avoid infection of the fetus and premature birth, the woman is placed in a hospital where she undergoes a course of treatment.

Pregnant women have an increased risk of developing kidney infection

Diagnostics

First of all, the patient’s medical history is collected, an examination is performed, and a urine test is taken to find out whether there is a bacterial infection.

In case of complications of pyelonephritis, the patient is placed for inpatient treatment. It is also necessary to draw blood for a general analysis. The kidneys are checked for the presence of stones using an ultrasound or x-ray.

If the infection is protracted, complications such as an abscess, kidney swelling, and blood poisoning may occur (the infection enters the blood). The symptoms of the complication are clearly pronounced and cannot be ignored. People who have concomitant diseases are more susceptible to the occurrence of acute pathologies.

There are also several categories of people who are at risk of complications:

• Pregnant women.
• Elderly people.
• With diabetes.
• With the presence of chronic kidney disease.
• With weak immunity.

Bacteriological culture of urine is the only way to identify the causative agent of a kidney infection

Treatment

For all infectious diseases associated with the kidneys, antibacterial, anti-inflammatory and symptomatic treatment is prescribed. The following medications are prescribed:

• Antibiotics - first, broad-spectrum drugs are prescribed, and when the causative agent of the disease is identified, an individually selected drug is prescribed.
• Disinfection solutions intravenously - cleanse the body and blood.
• Anti-inflammatory drugs - to eliminate inflammatory processes. This allows the patient’s condition to improve in a short period of time.
• Diuretics – to improve kidney function and prevent urinary stagnation. For this, diuretics are prescribed.
• Antihypertensive drugs - to normalize blood pressure, as a rule, they lower it.
• Antispasmodics – relieve spasms and improve urine flow during genitourinary tract infections.
• Painkillers – relieve pain.
• Antipyretics – to lower body temperature.

In the presence of chronic forms of pyelonephritis, constant relapses are observed, so it is necessary to remove the primary focus of the disease. For this, either surgical or complex therapy is used.

Urgent surgical intervention is performed if available.

During the operation, the entire kidney or part of it is removed, then a drainage is installed to ensure the release of pus.

Antibiotics are the mainstay of treatment for any kidney infection.

ethnoscience

Milder forms of pyelonephritis can be treated at home. Also, during treatment, you need to follow a diet that includes low salt intake, and it is also necessary to exclude protein foods.

Traditional medicine recipes are often used as an additional measure:

• It is necessary to drink at least two liters of water per day, which will increase the amount of urine output, which removes bacteria from the body.
• Drink a glass of water with a spoonful of soda dissolved in it 2-3 times a day, this will make it possible to cleanse the body of toxins.
• Eating blueberry mousse will help remove pathogenic bacteria from the body.
• Add a spoonful of vinegar to a glass of water and drink it in the morning on an empty stomach. This recipe helps stop the inflammatory process and improve digestion.

Infectious processes in the kidneys must be treated in order to avoid chronic forms of the disease, which often lead to kidney failure and can sometimes cause human disability.

Pregnancy is not only pleasant moments of waiting to meet your baby, but also a complete transformation of the functionality of all internal systems and organs. A woman’s body experiences severe stress, especially in the last trimester. During this period, the immune system decreases, physiological changes in the urinary system occur and all the conditions are created for the formation of infection in the kidneys. In this article we will talk about kidney infection during pregnancy, its symptoms, causes of formation and treatment methods.

Causes of infection

The formation of infections of the genitourinary system during pregnancy is considered the most common. According to statistics, 10% of pregnant women suffer from such infections:

• pyelonephritis;
• acute cystitis;
• bacteriuria is asymptomatic.

The reason for the formation of bacteria in the genitourinary system is the anatomical feature of the structure of the female genital organs. The genitourinary organs are located close to the anus, which is quite short, which in turn facilitates the movement of bacteria through the canal to the kidneys and bladder. During pregnancy, the urinary system:

• reduces the ability of muscles to contract in different parts;
• the renal pelvis expands and increases in size;
• the ureters acquire an elongated shape;
• the kidneys are displaced;
• the movement of urine slows down.

For information! Progesterone is able to relax the muscles in the body of a pregnant woman, resulting in stagnation of urine and the proliferation of bacteria and microorganisms.

As a rule, the main changes in the female body occur at the 12th week of pregnancy, which contributes to a greater risk of infection in the kidneys. Another reason for the formation of the disease can be simple non-compliance with personal hygiene rules, chronic forms of diseases and endocrine system disorders.

Symptoms of the disease

All infectious diseases of the urinary tract have almost the same symptoms, which manifest themselves in:

• constant desire to go to the toilet, provided the bladder is almost half empty;
• attacks of pain in the lower abdomen and lumbar region;
• feeling of discomfort or burning during urination or sexual intercourse;
• the urine becomes cloudy, may have an unpleasant odor or may contain blood clots.

For information! During the infectious period, low-grade fever can rise to 37.5C ​​degrees, but most often the temperature remains normal.

Symptoms of a kidney infection can occur either unnoticed by a woman or appear suddenly, they are expressed:

• increased sweating, chills;
• fever or sudden increase in temperature;
• attacks of nausea and vomiting;
• severe pain in the lower abdomen, side, and hypochondrium.

For information! Asymptomatic bacteriuria leads to the premature birth of a child with low birth weight. If the disease is left untreated, the risk of developing a kidney infection increases to 40%.

Most often, a woman does not immediately notice an infection, for example, cystitis, because... Due to fetal growth, the number of urinations increases. However, if you notice any changes, contact a specialist immediately.

Diagnosis of kidney infection

The diagnosis and treatment are determined only after laboratory testing. A pregnant woman is prescribed:

• bacteriological examination of urine;
• urine analysis using the Nechiporenko method;
• general urine analysis;
• general blood analysis.

All tests are taken once a month by every pregnant woman; if necessary, the attending physician may ask for additional tests. If a preliminary laboratory report confirms the presence of the disease, instrumental diagnosis is prescribed using:

• ultrasound examination of the urinary system, kidneys and adjacent organs;
• radioisotope research;
• X-ray examination;
• computed tomography.

For information! Ultrasound allows you to determine the size, damaged structure and changes occurring in the kidneys.

Most often, diagnosis consists solely of ultrasound, this is due to the possible mutagenic effect of the equipment on the fetus.

Treatment methods for kidney infection during pregnancy

Treatment of infectious diseases of the urinary tract in pregnant women takes place exclusively in a hospital under the supervision of the attending physician. Only the attending physician is able to give an adequate assessment, as well as calculate the possible risks of the effects of drugs on the woman’s body and the development of the fetus. The treatment method depends on the infection that has struck; let’s look at the most common ones:

• Cystitis - treatment is carried out without taking antibiotics, protected drugs of penicillin or cephalosporin are prescribed, the course of treatment lasts two weeks. After the symptoms have resolved, a repeat urine test is performed.
• Pyelonephritis - if a pregnant woman has severe symptoms of infection, she is admitted to a hospital and treated with intravenous antibiotics. During therapy, the general condition of the woman and fetus is monitored; this is necessary to avoid premature birth.

For information! To avoid relapse, it is recommended to undergo antibacterial therapy. Canephron is prescribed as a medicine; it contains herbal components that have a diuretic and anti-inflammatory effect.

In case of a pronounced exacerbation of a kidney infection in the third trimester and the presence of fever and intoxication of the body, the woman undergoes an unscheduled cesarean section to preserve her life and the fetus.

Disease prevention

The main danger of developing an infection during pregnancy lies in its irreversible processes and negative impact on the health and development of the fetus. Complications of a kidney infection may include:

• anemia;
• formation of gestosis;
• formation of toxic shock;
• surges in blood pressure;
• insufficiency and inflammation of the placenta;
• lack of oxygen for the fetus;
• premature labor;
• death of the fetus.

To prevent and preserve the health and life of the mother and fetus, experts recommend taking the following measures:

• pregnancy planning, timely examination and treatment of all chronic diseases;
• normalize hormonal levels with the help of medications;
• in the absence of severe swelling, drink a sufficient amount of fluid;
• do not restrain yourself at every urge to urinate;
• during pregnancy, avoid douching;
• observe personal hygiene rules, wear loose underwear and do not take a bath;
• take tests in a timely manner and report the presence of suspicious symptoms;
• If you have a chronic disease, take herbal medicines.

Remember, any infection of the genitourinary system during pregnancy has a number of its own characteristics and indications. Register with the antenatal clinic in a timely manner, take the necessary tests, and most importantly, always report any symptoms or phenomena that cause discomfort. Remember, timely treatment is the key to the health of not only the pregnant woman, but also the unborn baby.