A slight growth in kidney size is detected during pregnancy.
However, larger changes are increases in the kidney's leaching rate and the
amount of blood supply. These changes may also change according to the position
of the pregnant woman. In pregnancy, the reabsorption of nutrients from the
kidneys decreases, losses occur. A small amount of protein loss can also be
detected recently. Urine bleeding may also occur after difficult births.
As the left intestine pushes the uterus to the right, the
pressure on the right urinary tract mostly results in enlargement in the right
but both kidneys, and the urine waits more and the susceptibility to infections
increases. Urinary tract infections are more common in pregnancy. For patients
with a history of recurrent urinary tract infection or pyelonephritis,
suppressive therapy can be started as soon as pregnancy is detected.
We can
examine the urinary tract infection in pregnancy under three headings:
Asymptomatic
Bacteriuria (ASB):
It is defined as the presence of bacteria that proliferate in
the urine with the absence of signs of infection in the patient. It is
diagnosed in the midstream urine culture with more than 100 thousand colonies
of bacteria. ASB is associated with low birth weight and preterm birth. The
prevalence of ASB varies around 5-7% during pregnancy. If left untreated, ASB
can progress to acute pyelonephritis in about 30% of pregnant women. If ASB is
treated with appropriate antibiotics, this rate drops to 3%. All women should
be screened for bacterial urine at the first examination.
Acute
Cystitis:
It occurs in about 1% of pregnant women. Diagnosis of
cystitis is based on symptoms of increased urinary frequency, urge to urinate,
pain when urinating, bloody urine, pain on the bladder. Acute cystitis
bacteriology is the same as asymptomatic bacteriuria and similar treatment is
recommended. Acute cystitis is not directly related to the risk of preterm
labor, as opposed to asymptomatic bacteriuria and pyelonephritis.
Acute
Pyelonephritis:
It is seen in 2% of all pregnancies. Major symptoms are high
fever, flank pain, nausea and vomiting. Frequent urination, a sudden urge to
urinate, and pain when urinating may be present. The risk of preterm labor and
premature rupture of membranes may increase. There are also negative
consequences for pregnant women. For example, bacteraemia, sepsis, adult
respiratory distress syndrome, and hemolytic anemia. These complications can be
seen in pregnant women due to increased sensitivity to bacterial endotoxins and
may be life threatening.
Treatment: Must be
hospitalized in an emergency hospital, intravenous (intravenous) fluid therapy,
antipyretic use and broad-spectrum antibiotics should be given intravenously.
Antibiotic therapy should be continued until the patient has spent at least 48
hours without a fever. Antibiotic treatment should be continued as required
according to the results of urine culture susceptibility. If there is no change
in the findings after 72 hours despite appropriate treatment, antibiotic
susceptibility test results and the dose administered should be reviewed and
kidney ultrasonography should be performed to detect anatomical anomalies.
After the resolution of acute pyelonephritis, the patient should continue antibiotics
for a total of 2 weeks and suppressive therapy should continue in the
continuation of pregnancy. The recurrence rate is about 20%.
-COLD AND FLU IN PREGNANCY
-SYPHILIS INFECTION IN PREGNANCY
-CHICKENPOX AND SHINGLES INFECTION IN PREGNANCY
-TOXOPLASM INFECTION IN PREGNANCY
