Acute pyelonephritis in pregnancy
Acute pyelonephritis in pregnancy
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DOI：
10.1097/01.aog.0000149154.96285.a0
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发表时间：
2005-01-01
影响因子：
7.2
通讯作者：
Wendel, GD
中科院分区：
文献类型：
--
作者：
Hill, JB;Sheffield, JS;Wendel, GD
目的：探讨肾盂肾炎的发病率和发病的危险因素，微生物病原体，产科并发症的妇女与急性产前肾盂肾炎。方法：2年来，资料收集孕妇急性肾盂肾炎的纵向研究。所有妇女都入院接受静脉注射抗菌药物治疗。我们比较了这些妇女的妊娠结局与一般产科人口收到在我们的医院在同一时间period.Results：四百四十例急性产前肾盂肾炎确定在研究期间（发病率1.4%）。虽然种族之间没有显著差异，但肾盂肾炎与未产（44%对37%，P = 0.003）和年轻（P = 0.003）有关。13%的女性有肾盂肾炎的已知危险因素。急性肾盂肾炎多发生在妊娠中期（53%），主要泌尿系病原体为大肠埃希菌（70%）和革兰氏阳性菌，包括B β链球菌（10%）。并发症包括贫血（23%），败血症（17%），一过性肾功能不全（2%），肺功能不全（7%.CONCLUSION：肾盂肾炎的发病率一直保持在常规产前筛查无症状菌尿的时代低。妊娠早期肾盂肾炎占产前病例的五分之一以上。随着妊娠的进展，发现革兰氏阳性尿路病原体更常见。产妇并发症仍在继续，但产科结局不佳的情况很少见。(C)2005年由美国妇产科医师学会。
OBJECTIVE: To examine the incidence of pyelonephritis and the incidence of risk factors, microbial pathogens, and obstetric complications in women with acute antepartum pyelonephritis.METHODS: For 2 years, information on pregnant women with acute pyelonephritis was collected in a longitudinal study. All women were admitted to the hospital and treated with intravenous antimicrobial agents. We compared the pregnancy outcomes of these women with those of the general obstetric population received at our hospital during the same time period.RESULTS: Four hundred forty cases of acute antepartum pyelonephritis were identified during the study period (incidence 1.4%). Although there were no significant differences in ethnicity, pyelonephritis was associated with nulliparity (44% versus 37%, P = .003) and young age (P = .003). Thirteen percent of the women had a known risk factor for pyelonephritis. Acute pyelonephritis occurred more often in the second trimester (53%), and the predominant uropathogens were Escherichia coli (70%) and gram-positive organisms, including group B beta Streptococcus (10%). Complications included anemia (23%), septicemia (17%), transient renal dysfunction (2%), and pulmonary insufficiency (7%).CONCLUSION: The incidence of pyelonephritis has remained low in the era of routine prenatal screening for asymptomatic bacteriuria. First-trimester pyelonephritis accounts for over 1 in 5 antepartum cases. Gram-positive uropathogens are found more commonly as pregnancy progresses. Maternal complications continue, but poor obstetrical outcomes are rare. (C) 2005 by The American College of Obstetricians and Gynecologists.