The occurrence of acute pyelonephritis within the duration of pregnancy increases lower urinary tract infection that has been closely associated with the upper urinary tract infection. The association of asymptomatic bacteriuria includes risk factors for lower urinary tract infection in pregnancies with multiparity, diabetes mellitus, urinary tract malformations, low socioeconomic status, and preterm labor delivery. The detrimental asymptomatic bacteriuria within the upper urinary tract as well as the lower urinary tract that may cause issues of adverse perinatal outcomes includes preterm delivery and low neonatal birth weight (5-8). The progression of pyelonephritis in nonpregnant women is only 1% to 2% whereas ASB in pregnant women will progress into pyelonephritis in 20-40% cases. This increasing chance of infection in the maternal body is due to immunosuppression normally during pregnancy; Allowing increase growth of Escherichia coli in association to the lower and upper UTIs, the acute pyelonephritis in pregnancy continues to scale significant numbers in maternal and fetal morbidity. Maternal sepsis, renal failure, and respiratory insufficiency are among the associations found between pyelonephritis and maternal-fetal compromise [3]. Due to most pyelonephritis cases presented in the second to third trimester of gestational period, the threat of preterm delivery can result in tocolytic administration, which risks for pulmonary edema and respiratory insufficiency (6). Pyelonephritis infection may trigger a cytokine inflammatory response that induces labor uterine contractions.
REFERENCES
1) Duff P. Pyelonephritis in pregnancy. Clinical Obstetrics and Gynecology 1984; 27: 17-31.
2) Wing DA. Pyelonephritis. Clin Obstet Gynecol 1998;41(3):515–26)
3) Gazmararian JA, Petersen R, Jamieson DJ, Schild L, Adams
