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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The obstetric experiences of 128 gravidas delivered at Charlotte Memorial Hospital in 1973 who, on hemoglobin electrophoresis, exhibited an SA pattern of hemoglobin are reviewed. In addition to previously reported complications of increased rates of pyelonephritis and refractory anemia, this group of patients exhibited a marked increase in premature rupture of membranes and prematurity. It is suggested that the routine screening procedures be used for discovering sickle-cell trait individuals and that they be categorized as "high-risk" obstetric patients because of the increased complication rates described here and by previous authors.
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PMID:Sickle-cell trait and pregnancy: A review of a community hospital experience. 118 Feb 85

A prospective study was carried out in which quantitative clean-voided urine cultures, were obtained at the first clinic visit from 986 consecutive pregnant women, followed to delivery to assess the maternal and pediatric finding associated with maternal asymptomatic bacteriuria. Patients to be evaluated were divided in two groups: Treatment group (TG) with 42/46 patients that were treated with nitrofurantoin 100 mg a day during 10 days, and control group (CG) with 45/46 patients that were not treated. Patients who failed were given a second course of nitrofurantoin. The patients who remained infected were given further treatment (cephalexin). Primary treatment was successful in 85%, 10% more with the second course and 5% were failure treatment. There was a highly significant difference in the incidence of symptomatic bacteriuria (pyelonephritis), premature deliver, prematurity and other perinatal events in patients with persistent infection. Eradication of asymptomatic bacteriuria reduced the risk of pre-term deliveries and lower infant birth weights for gestational age.
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PMID:[The prevention of urinary infection during pregnancy in patients with asymptomatic bacteriuria]. 248 9

Screening women for asymptomatic bacteriuria on the first prenatal visit is a standard of obstetric care. Treating women with positive results decreases the risk of pyelonephritis and possible prematurity. This study uses decision and cost analysis to compare the utility of screening for asymptomatic bacteriuria with not screening. Data are based on published reports and average charges for services. Costs are based on 1988 charges, projected for the expected results of outpatient screening, possible suppressive therapy, and risks of pyelonephritis. Screening is based on the combined sensitivities and specificities of the MacConkey and CLED (cysteine-lactose-electrolyte-deficient agar) panels of the dip-slide culture. Under the baseline assumptions, the risk of pyelonephritis is estimated to be 2 cases per 100 screened women vs 3.5 cases per 100 unscreened women. The anticipated cost of screening 100 women is $9,939, compared with $12,824 for not screening 100 women. Screening is cost saving unless the cost of screening is above $26, the length of hospitalization for pyelonephritis is fewer than 2.2 days, the risk of asymptomatic bacteriuria falls below 2%, the risk of pyelonephritis with asymptomatic bacteriuria falls below 13%, or the efficacy of treatment in preventing pyelonephritis falls below 38%.
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PMID:Screening for asymptomatic bacteriuria in pregnancy. A decision and cost analysis. 210 74

A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls. Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity. Silent chorioamnionitis has been noted in 15% of patients in premature labor. Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear. Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria.
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PMID:Microorganisms and premature labor. 327 13

There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms. No difference was found in the incidence of prematurity on low birthweight between that group and a control group of gravidas from the same population. Members of the Enterobacteriaceae genus were the most common bacterial isolates from the urine, with a large portion of E. coli being resistant to both ampicillin (33%) and cephalothin (13%). Treated pyelonephritis associated with pregnancy does not appear to predispose to prematurity or low birthweight in this population. Also, initial therapy with a first-generation cephalosporin may no longer be appropriate, because a significant number of isolates (11%) were resistant to cephalothin.
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PMID:Acute pyelonephritis in pregnancy. 330

Excess perinatal morbidity and mortality continue to be major problems in developed and developing nations. Most perinatal deaths occur in infants born weighing less than 2500 g. Large expenditures of time, equipment, and personnel have led to striking reductions in neonatal mortality. However, rates of prematurity have not declined. Exploration of proven causes of prematurity and low birth weight suggests a role for infection that has hitherto not received sufficient attention. Women with symptomatic pyelonephritis, even when treated promptly, experience an excess of prematurity and perinatal death, and their children have lowered intelligence scores and neurologic scores. Women with asymptomatic bacteriuria experience higher rates of low birth weight and perinatal mortality, as well as symptomatic pyelonephritis, and these are preventable by screening and treatment during pregnancy. Recent evidence also suggests that genital mycoplasmas (Ureaplasma urealyticum and Mycoplasma hominis) are a cause of prematurity and that treatment of women colonized with these organisms results in significant reduction in prematurity rates.
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PMID:Infectious disease and perinatal morbidity. 718 23

In the Swiss Study "HIV and pregnancy" we observed 153 singleton pregnancies of HIV-positive women. 23 (15%) of those ended with a premature delivery. For drug addicts (n = 100), the incidence of prematurity, 20%, significantly higher than in those free of drugs (n = 53) with 5.6%. The most frequent cause of prematurity was premature labor or rupture of the membranes (n = 13), followed by maternal illness (n = 8) and fetal complications (n = 2). Women with premature delivery tended to have lower CD4 cell counts than those with term delivery (29.4% vs 12.0% with < 200 CD4 cells/microliters). Low CD4 cell counts and drug consumption are two independent but cumulative risks for severe infections. 16 of the 153 women (12 with, 4 without drug consumption) had severe infections during pregnancy; in 4 cases (25%), this led to prematurity. The most common infection was pneumonia (14/16), further one case of pyelonephritis and one of cerebral toxoplasmosis. Two of these 16 infants (12.5%) were HIV-positive. We could not confirm a relationship between prematurity and vertical HIV transmission. Of the HIV-classified children, 3/18 (16.7%) premature infants and 16/74 (21.6%) term infants were infected.
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PMID:[Premature labor in HIV infected women. Swiss "HIV and Pregnancy" Study Group]. 778 79

The purpose of this study was to investigate the perinatal morbidity and mortality in all the diabetic pregnancies seen at the HGO-"LCA" from January 1992 to December 1993. In that period 186 women (mean age 31 yr) were diagnosed as having diabetes during pregnancy: 54% of them had DMG, 40% DM-II and 6% DM-I, with serum glucose concentration of 133 +/- 41 mg/dL. Neonatal morbidity was given by macrosomia (17%), prematurity (14%), hyperbilirubinemia (11%), hypoglycemia (8%), congenital malformation (6%) and hypocalcemia (4%). Perinatal mortality was 5.3%. The principal causes of maternal morbidity were preeclampsia (17%), polyhydramnios (16%), pyelonephritis (4%) and ketoacidosis (0.05%). Cesarean section was performed in 62% of all diabetic patients. There was not any maternal death. This results showed a high perinatal morbidity-mortality in pregnancies complicated by diabetes mellitus which reclaim a better metabolic control during gestation period.
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PMID:[Perinatal morbidity and mortality in pregnant women with diabetes mellitus]. 778 45

528 pregnancies of primiparous girls 13-17 years old who gave birth during 1988-90 at the obstetrical ward of the city of Pleven, Bulgaria, were evaluated. The pregnancy outcome and neonatal results were compared with those of 100 controls. These 528 births amounted to 5.48% of a total of 9635 births at the clinic. These girls were of low socioeconomic status, 14.2% were illiterate or had low educational attainment, and 56.42% were of Gypsy origin, without skills, and from rural areas. Only 32.89% of the Bulgarian girls had an official marriage license. Anemia was found in 13.64%, kidney infection (without symptoms of bacteriuria, pyelonephritis) in 6.44%, preeclampsia in 2.46%, and eclampsia in 0.76%. The most frequent occurrence was premature rupture of the membrane (9.85%). Term deliveries numbered 433 and preterm deliveries 95. There was a statistically significant difference between the two groups with respect to term and preterm deliveries (p 0.01). Dystocia amounted to 2.8% and instrumental delivery to 1.70% among these adolescent girls. The rate of premature delivery reached 17.99%, and cesarean section was performed in 5.44%. There was a significant difference between the two groups with respect to vaginal delivery (p 0.01) and cesarean section (p 0.01). 44% of 16-year old girls underwent cesarean section; and there was a significant difference in the rate of cesarean section between 14-year-old and 17-year-old girls (p 0.05) as well as between 16-year-old and 17-year-old girls (p 0.01). 71.95% of newborns had a birth weight of less than 3000 g. There was also a significant difference between the groups with regard to term and prematurely born neonates (p or = 0.01). Intrauterine growth retardation reached 2.46% because of the inadequate uterine size of girls 13-14 years old, insufficient weight gain during pregnancy (under 9 kg), and complications (preeclampsia and eclampsia). The rate of stillbirths was 7.63%, attributed to prematurity and malformation of the fetus. Maternal mortality reached 1.89% owing to pregnancy complications (eclampsia) among 17-year old girls because of low socioeconomic status and complete lack of prenatal care.
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PMID:[Pregnancy and labor in young girls]. 779 32

Urinary tract infections (UTIs) are one of the most frequent complications of pregnancy. When the lower UTIs of asymptomatic bacteriuria and cystitis are not eradicated, the subsequent risk of the development of pyelonephritis is increased. The associated decreased maternal morbidity and fetal prematurity are the goals of a screening and treatment program for pregnant women. This clinical article presents information on the etiology, incidence, diagnosis, and management of asymptomatic bacteriuria and cystitis. Nursing implications regarding teaching are included.
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PMID:Management of urinary tract infections in pregnancy. 800 1


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