According to statistics, about 12% of pregnant women face such a serious disease as pyelonephritis. It is characterized by an inflammatory process in the kidneys with damage to the pyelocaliceal system and the main tissue of the organs, parenchyma. Unfortunately, it is impossible to do without taking antibiotics. But their effect on the fetus, compared to the disease, is not so harmful. It is extremely important to know what the symptoms of pyelonephritis are during pregnancy in order to recognize the disease in time and begin treatment. Otherwise, everything could end tragically for both the mother and the unborn child.

Read in this article

Why does pyelonephritis begin?

The cause of the disease is microbes and microorganisms that live in the body of every person or penetrate into it from the outside. Doctors note that the following types of kidney infections most often provoke:

• staphylococci;
• fungi such as Candida;
• Pseudomonas aeruginosa;
• enterococci;
• enterobacteria;
• Proteus;
• coli.

In ordinary life, they coexist quite peacefully in the body. But with pregnancy, against the background of decreased immunity, microbes can begin to actively multiply, affecting kidney tissue, which leads to pyelonephritis. The following factors contribute to the development of the disease:

• disruption of the outflow of urine from organs due to formations in the kidneys;
• urolithiasis disease;
• narrowed ureter;
• stress;
• unhealthy diet and lifestyle;
• chronic fatigue;
• lack of vitamins

What is pyelonephritis?

Doctors divide the disease into primary and secondary. In general, there are quite a lot of its varieties. Primary manifests itself as an independent disease and is rarely found in pregnant women. But secondary pyelonephritis occurs against the background of other diseases of the genitourinary system. This is what doctors diagnose most often.
In a pregnant woman, the course of the disease can take two forms:

• Acute pyelonephritis. In this case, the disease develops quite quickly and suddenly. However, in its acute form, with the right approach, the disease is easier to treat. Just 10-20 days - and the patient completely gets rid of pyelonephritis with minimal damage to the body.

If a pregnant woman develops the disease more than two or three times during pregnancy, then a diagnosis of “chronic pyelonephritis” is written down on the card and she is forced to take urine tests more often so as not to miss the onset of the acute phase.

How do the symptoms of the disease manifest themselves?

Pyelonephritis during early pregnancy manifests itself in the following symptoms:

• sharp or dull pain in the lumbar region, aggravated by bending forward;
• change in the natural color and consistency of urine (it becomes cloudy, with a reddish tint, sharp and sharp);
• a pregnant woman's body temperature is up to 38-40 degrees;
• Nausea or vomiting may occur;
• decreases;
• the expectant mother feels chills, general weakness,...

It is quite difficult to identify chronic and sluggish pyelonephritis during pregnancy, the symptoms of which are almost invisible. The main symptom of the disease is low temperature for a long time.
Signs of pyelonephritis during pregnancy can be noticed when urinating: it becomes painful and frequent. In addition, even for short periods of time, symptoms that are uncharacteristic for a given period are felt.

Why is pyelonephritis dangerous during pregnancy?

The main danger of the disease lies not only in changes in the mother’s kidney tissue and other side effects, but also in the threat of spontaneous abortion or miscarriage. After all, the child in the womb also suffers from infection. If you manage to maintain the pregnancy, over time, after the disease suffered in the womb, the baby may experience both minor consequences in the form of conjunctivitis and serious damage to internal organs. Under the influence of pyelonephritis, the fetus may also suffer from a lack of oxygen, which will subsequently lead to developmental problems and low weight.

As soon as you feel pain in your side, consult a doctor immediately! Pyelonephritis detected at an early stage is easier to treat, and the effects of medications are not as harmful to the baby as the result of the disease. It is prohibited to treat yourself, listening to friends or using grandma’s recipes! With such careless treatment of your health, you can end up with a lot of side effects that are dangerous for both mother and child.

For the mother, an advanced disease threatens to go into the abscess stage (the formation of a cavity with pus in the organ), and in the third trimester it can provoke a severe one. And changes to tissues will not lead to anything good.

How do I diagnose a disease?

To detect pyelonephritis, a pregnant woman will be prescribed the following tests:

• general blood and urine analysis;
• Gram stain of urine;
• bacteriological examination of urine;

All these methods will help to clarify the cause of the disease, the complexity of its course, as well as the degree of organ damage, tissue deformation, and the presence of internal seals.

It is worth noting that in the initial stage of development, pyelonephritis is similar to cystitis. To understand how they are the same and how they are fundamentally different, we recommend reading the article. From it you will learn how this disease manifests itself, whether it may indicate the onset of pregnancy, and also what to do if fears about its development are confirmed.

Most often, treatment of pyelonephritis in pregnant women takes place under the strict supervision of doctors in a hospital. It is aimed at suppressing the growth of infections, and this can only be done with the help. Traditional medicine most often turns out to be not only useless, but also leads to delays before visiting a doctor and, as a result, aggravation of the situation!

The specialist will select antibiotics that will minimize the harm to the baby. For example, Monural or Amoxiclav are considered gentle for a child. If the disease has just begun, the pregnant woman may be offered therapy with herbal medicines. These include Canephron, Phytolysin or lingonberry leaves.

Additionally, the mother will be prescribed antispasmodic and painkillers. If you have a fever, Ibuprofen or Paracetamol will be prescribed simultaneously with taking antibiotics. To support the woman’s body, she will be prescribed sedatives and vitamins, offered physical therapy, and will also undergo positional therapy to eliminate the causes that led to the disruption of the outflow of urine. If an abscess or suppuration is diagnosed, the kidney is decapsulated or fibrous tissue is removed. In advanced cases, the entire organ has to be removed. Of course, it is impossible to save the child with such a diagnosis, so doctors insist on artificial termination of pregnancy.

After treatment and childbirth, the woman registers with the dispensary so that specialists have the opportunity to promptly identify and treat the disease if it remains uncured.

How to live and bear a child with pyelonephritis

Just like with many other diseases, pyelonephritis obliges a woman to lead a healthy lifestyle, follow a sleep and rest schedule, and eat right. For example, if an acute course of the disease is diagnosed, then you should drink as much fluid as possible, more than the usual 2 liters per day.

A diet for pyelonephritis for an expectant mother is that she will be advised to eat a lot of fruits and vegetables, and avoid spicy, sour, fatty and fried foods. You should also be extremely careful with salt, because it promotes fluid retention in the body. It is allowed to consume no more than 8 g per day. It is worth giving preference to first courses on water, or boiling them in a second broth. Don't forget to take in as many vitamins as possible!

If the disease occurs in an acute stage, the pregnant woman is advised to remain in bed. No need to be upset, it's only for 4-8 days. Then, on the contrary, they will suggest that you move actively to promote the outflow of urine.

Preventive methods against the disease

Unfortunately, pyelonephritis is a disease from which no one is immune. Among the preventive methods, the following can be noted:

• healthy lifestyle;
• visiting the toilet on time;
• maintaining personal hygiene;
• timely treatment of diseases that impede the outflow of urine;
• take care of your health and avoid hypothermia.

It is worth noting that it is possible to protect the body from serious complications only with timely examination by doctors and treatment if symptoms of pyelonephritis are detected. You should not wait and, especially, treat yourself. After all, this can not only lead the disease to a chronic state, but also cause irreparable harm to yourself and the child.

It is one of the most common diseases of pregnant women and poses a danger to the health of mother and child. It occurs in every tenth pregnant woman, and in some cases leads to severe complications, both during pregnancy and after it.

To this we can add that pregnancy itself is a provoking factor leading to the development of acute forms of pyelonephritis. Of course, this causes a more severe course of already formed chronic kidney disease.

Why does chronic pyelonephritis worsen during pregnancy?

During pregnancy, some body functions change, which can cause illness.

The main reason is a violation (more precisely, a complication) of urine passage, due to changes in the location and size of the uterus, as well as the effect of progesterone on the internal receptors of the urinary tract.

The uterus (in the second half of pregnancy) deviates slightly and turns to the right, putting pressure on the right kidney. This, by the way, explains the fact that during exacerbation of pyelonephritis in pregnant women, as a rule, it is the right kidney that suffers more. In the organ itself, an expansion of the urinary elements (pyelocaliceal system) is observed, and the ureters expand. The capacity of the urinary tract increases to 50-70 ml (per kidney).

Congestion in the kidney can be caused by oversaturation of urine

The kidney and ureter, overloaded with urine (congestion and high blood pressure), find themselves in a situation favorable for exacerbation of chronic pyelonephritis. In this case, primary pyelonephritis can also form.

These processes are observed in pregnant women with kidney diseases from the 3rd to the 8th month (before the descent of the fetus).

From the 8th month there is an improvement in the condition of the pregnant woman. The kidneys finally return to normal, as a rule, by the 4th month after birth.

Factors provoking exacerbation

The condition of the ligamentous apparatus of the kidneys, as well as the condition of the fat capsule, plays a significant role.

If pregnancy is combined with low body weight, the likelihood of exacerbation of pyelonephritis increases significantly. Try to adjust your diet accordingly during the first trimester.

Of course, the current condition of the kidneys plays a role, as well as the severity of vesicoureteral reflux (i.e., backflow of urine).

Often, exacerbation of pyelonephritis is associated with peak hormone levels, which is quite typical for pregnant women.

In this case, the problem is not so much in the dysfunction of the kidney valve apparatus, but in the influence of estrogen and progesterone on certain types of receptors. A gynecologist-endocrinologist can suspect this situation in time and help correct it.

Even in the absence of a focus of chronic infection in the body (or with its relative passivity), in pregnant women the infection quite often rises from the bladder or spreads through the lymphatic or circulatory tract.

In the first case, this is facilitated by congestion in the ureters and the kidneys themselves, in the second - a drop in immunity, which is not uncommon during pregnancy.

As a result, an exacerbation of chronic pyelonephritis, or acute kidney infection (acute

The causative agent is most often Escherichia coli, Proteus, Enterococcus, Staphylococcus, Candida.

How dangerous is the disease during pregnancy?

Early toxicosis may be a consequence of exacerbation of chronic pyelonephritis

Exacerbation of pyelonephritis leads to early gestosis (toxicosis), with developed symptoms: pressure rises, edema develops, and there may be convulsions. There is loss of protein in the urine.

Preeclampsia, as is known, is still the main cause of maternal mortality.

Against the background of exacerbation, miscarriages and premature births quite often occur. The placenta can detach prematurely, which also leads to miscarriage.

With severe immunodeficiency of the mother, the fetus can be infected with a pathogen that initiates an exacerbation of pyelonephritis. In this case, the child may develop abnormally because his tissues experience hypoxia (lack of oxygen and nutrients).

After exacerbation during pregnancy, pyelonephritis in the period after childbirth is much worse, which affects the quality of life of the mother.

Severe complications of the disease: sepsis (septicemia, septicopyemia), toxic (bacterial) shock. Given the high mortality of these conditions, pregnant women with pyelonephritis are always considered a high-risk group.

If you have (or have had at least once) pyelonephritis or any other kidney disease, be sure to tell your gynecologist about it.

Symptoms of chronic pyelonephritis in expectant mothers

The chronic form can last for quite a long time in the absence of a comprehensive clinic. More precisely, some pain in the lower back is present, as is a slight increase in body temperature, but the patient often does not attach due importance to this.

This occurs either due to the abundance of “special effects” characteristic of pregnancy as a condition (vomiting, bloating, taste disturbances, irritability, etc.), or due to the habit of constant pain from the kidneys (if undertreated or severe pyelonephritis, urolithiasis, etc.).

Signs in the photo

General weakness Nausea and vomiting Change in urine color and odor Increased body temperature

Weakness gradually increases, and the color of urine may change. All this, by the way, can also be attributed by the patient to the pregnancy itself, especially if it is the first pregnancy. Pain in the lower back appears, which can be either dull or sharp (stabbing). The pain usually intensifies when the body bends forward.

At the first signs of exacerbation of chronic pyelonephritis in a pregnant woman, it is necessary to call a doctor

Exacerbation of the chronic process is accompanied by the following phenomena:

• Body temperature rises to 39-40 0C, chills appear;
• The pregnant woman begins to feel sick, even vomiting, and her appetite decreases;
• The urine may have a strong and unpleasant odor. The color may become reddish;
• Severe general weakness.
• high body temperature (38–40 degrees);

Doctors differentiate exacerbation with acute appendicitis, colic, cholecystitis, as well as nephropathies and manifestations. It will not be possible to figure it out on your own, so if the symptoms described above are present, the pregnant woman is hospitalized.

During an exacerbation of chronic pyelonephritis (even if suspected), the pregnant woman absolutely must be hospitalized.

Risk levels

There are 3 levels of risk to prevent maternal mortality. The first includes uncomplicated primary pyelonephritis during pregnancy. In this case, there are no special contraindications to pregnancy.

If a woman had chronic pyelonephritis before pregnancy, she already falls into the second risk group.

The first and second groups are additionally observed by a nephrologist or therapist, and most of these pregnancies are resolved safely.

If pyelonephritis is combined in a pregnant woman with hypertension, anemia, or there is only one kidney, pregnancy is contraindicated.

Of course, you can keep the fetus, but you will have to sign a lot of necessary documents and listen to several specialized specialists. The risk to your life in this case is quite real, and the health of the fetus is at risk right up to (and during) the birth.

Treatment of chronic pyelonephritis in pregnant women

One aspect of treatment is detoxification therapy

Pyelonephritis is treated according to strict principles of therapy, i.e. the pathogen is sown, an antibiotic is selected for it, taking into account contraindications and side effects of the drug. You need to understand that the benefit/risk ratio can go quite far beyond the boundaries of the drug instructions.

The need to prescribe this or that drug is due to concern for the safety of the mother and fetus. Since life is the highest value, the prescription of non-indicated drugs during exacerbation of chronic pyelonephritis in pregnant women is allowed.

In addition to antibiotics, vitamins, mineral waters (Essentuki No. 20), antispasmodics and diuretics, physiotherapy and exercises are prescribed.

The pregnant woman undergoes detoxification therapy - rheopolyglucin, protein solutions, hemodez are dripped. To prevent fetal developmental disorders, trental is prescribed (reduces tissue hypoxia).

If treatment is not effective enough, catheterization of the ureters can be performed to ensure stable passage of urine.

An exception may be very strict obstetric indications, for example, a discrepancy between the linear parameters of the small pelvis and the child’s head.

If pyelonephritis is accompanied by severe toxicosis, early delivery is performed.

The woman in labor is observed in the hospital for 10 days, after which she is discharged from the maternity hospital home, under the supervision of a nephrologist (urologist).

If you follow simple nutritional rules, the risk of exacerbations can be reduced

It is necessary to drink a lot of fluid (more than 2 liters per day), avoid fried, spicy and fatty foods. In the absence of combined pathologies of the digestive system, it is advisable to eat a lot of vegetables and fruits every day.

Meat, fish and mushroom broths are contraindicated (meat, fish and mushrooms can be added to vegetable and cereal broths), since extractive substances can provoke an exacerbation of pyelonephritis.

To reduce the load on the kidneys, it is necessary to reduce the consumption of table salt (total consumption per day is up to 8 g).

When the first signs of exacerbation appear, strict bed rest is indicated. During the period of remission, on the contrary, it is advisable to be quite active, as this improves the flow of urine.

Compliance with these rules, plus timely consultations with specialized specialists, significantly reduces the risk of exacerbation of chronic pyelonephritis during pregnancy. At the first signs of an acute process (fever, weakness, lower back pain), call a doctor immediately.

Video: Pyelonephritis in pregnant women

Pyelonephritis is one of the most frequently diagnosed kidney pathologies during pregnancy, which affects up to 12% of women. This is a urinary tract disease in which inflammation of the renal collecting system develops, caused by a bacterial infection. Doctors call the development of pathology during the period of bearing a baby “gestational pyelonephritis.” How dangerous is pyelonephritis, what complications during pregnancy can it lead to? How to treat pyelonephritis during pregnancy?

Pyelonephritis is a urological infectious disease. The infection affects the kidneys (calyces, pelvis) and leads to disruption of their functioning, affecting the urinary system. The risk of developing and developing kidney disease increases specifically in pregnant women, when the kidneys have to work under increased stress. In addition, the hormonal levels of a woman carrying a baby change. The activity of female hormones affects the functioning of the urinary system and kidneys, significantly reduces the tone of the ureter, and blood circulation in the organs is impaired. The longer the pregnancy, the more the actively growing uterus puts pressure on the ureter, preventing the outflow of urine from the kidneys, which leads to infection and the development of inflammatory processes in the organs. Sources of infection of the ureter and inflammation of the renal pelvis are pathogenic organisms (chlamydia, streptococci, E. coli, etc.).

Pyelonephritis during pregnancy is caused by the following reasons:

1. If pyelonephritis, cystitis, or renal failure have been observed in a woman previously.
2. Infection of urological organs with pathological microorganisms, which cause inflammation.
3. Hypothermia, weakened immunity of the pregnant woman.
4. Lack of moderate physical activity, walks in the fresh air, sedentary lifestyle.

Depending on when the woman first suffered inflammation, primary and secondary pyelonephritis are distinguished. If the disease was first diagnosed during pregnancy, this is the primary form of pyelonephritis. With secondary pyelonephritis, an exacerbation of the disease diagnosed before conception occurs.

Doctors make a diagnosis based on the form of the disease:

• Chronic form of pyelonephritis. The peculiarity of this form of the disease during pregnancy is hidden symptoms that may not appear or may make themselves felt periodically. Only through laboratory and bacteriological tests of urine can the presence of an infection in the kidneys be determined. This variant of the disease is observed in expectant mothers who previously suffered from pyelonephritis, and an exacerbation occurred during pregnancy.
• Acute pyelonephritis is manifested by sharp and sudden symptoms of the disease after infection. The disease develops in less than a day. Timely treatment contributes to a quick recovery without complications.

Pyelonephritis during pregnancy: symptoms

The main symptoms and first signs of the disease appear from the 2nd trimester (22-24 weeks of pregnancy), depending on the form of the disease.

• The acute form of pyelonephritis is usually accompanied by a high temperature of up to 38-40 degrees and chills. A pregnant woman feels a sharp pulling or sharp pain in the lumbar region, sometimes only on one affected side. Painful sensations and shooting pains from the lower back spread to the abdomen and perineum. The pain can be quite severe, making it difficult for a woman to get out of bed. There is a disturbance in the process of urination: the urine changes color, becomes cloudy, acquires a pungent odor, and sharp pain is felt when urinating. In addition to painful sensations, the pregnant woman feels body aches, lethargy, weakness, and nausea.
• Chronic pyelonephritis during pregnancy is not so pronounced and is manifested by tolerable pain in the lower back, which is aching and dull in nature. The pregnant woman feels weak, drowsy, and gets tired quickly. Sometimes the patient may not attach importance to pain, considering it normal during pregnancy. The pain may increase gradually, and the color and smell of the urine changes over time.

Pyelonephritis in early pregnancy - features of its course

Kidney disease that occurs in the 1st trimester (up to 12 weeks) is especially severe and painful. The pain is intense and resembles acute renal colic. The woman cannot relax, she is forced to take the only position that is comfortable for her at the moment, which slightly dulls the pain and curls up. The inflammatory process is very dangerous for the course of pregnancy and can lead to its termination.

In addition, there is a possibility of infection of the fetus and disruption of its normal development. Treatment of kidney inflammation is complicated by the fact that many drugs, including antibiotics, are not prescribed to pregnant women. The main task of doctors is to find the safest and most effective way to solve this problem in order to minimize the likelihood of complications and consequences after treatment.

Consequences of pyelonephritis during pregnancy

Expectant mothers who have had to deal with kidney inflammation are worried about the consequences and complications after the illness. Possible complications of pregnancy include:

• Exacerbation of chronic pyelonephritis in late pregnancy (up to 30 weeks) can cause premature birth.
• Kidney pathology in the 1st trimester threatens spontaneous miscarriage.
• Anemia is a frequent companion of a pregnant woman after suffering from pyelonephritis, and is dangerous due to complications - leading to forced oxygen starvation of the fetus.
• Infectious-toxic shock.
• The occurrence of acute renal failure, purulent inflammation in the kidney.
• Polyhydramnios.
• Gestosis in pregnant women is one of the most dangerous complications, manifested by increased blood pressure, which leads to vasospasm, swelling, and fetal hypoxia.

How dangerous is pyelonephritis during pregnancy for the fetus?

The consequences of pyelonephritis for the unborn baby are no less terrible. The intoxication that accompanies the disease has a negative impact on the condition of the fetus, causing disruption of the blood supply, which leads to fetal hypoxia. As a rule, after a disease suffered during pregnancy, the newborn is born with a low weight, and developmental delay is often diagnosed. Microorganisms that cause kidney inflammation can infect the fetus in the womb and lead to the formation of malformations or fetal death.

To avoid all the terrible consequences of this insidious disease, it is necessary to consult a doctor in time at the first symptoms and begin treatment prescribed by the doctor as quickly as possible.

Pyelonephritis in women during pregnancy - diagnosis

To diagnose kidney pyelonephritis during pregnancy, a number of laboratory tests are performed, on the basis of which the doctor prescribes appropriate treatment:

1. General and biochemical blood test - the level of leukocytes with pyelonephritis increases significantly, and hemoglobin decreases.
2. Urinalysis according to Nechiporenko - shows the level of immune cells of leukocytes in the urine. Their increased content is a clear sign of an inflammatory process.
3. General urine test - taken to identify protein and leukocytes in the urine.
4. Bacterial urine testing is used to accurately identify the causative agent of the disease, and its sensitivity to a specific group of antibiotics is also determined.
5. Ultrasound of the kidneys - as a rule, an ultrasound examination shows an enlargement of the organ and a change in its structure.

After the necessary research, the doctor prescribes treatment for the patient.

Pyelonephritis during pregnancy: treatment

Pyelonephritis is a disease with dangerous complications and consequences that requires treatment in a hospital under the supervision of qualified physicians. At the first, even slight, suspicion of kidney inflammation, a pregnant woman should consult a doctor. Only a doctor, after conducting an examination and tests, will prescribe treatment and select drugs that are safe for the fetus. While in the hospital, bed rest is mandatory. Physical activity is contraindicated for pregnant women; absolute rest is recommended. When treating a patient in the first trimester of pregnancy, if pyelonephritis is mild, doctors can prescribe non-drug treatment, which consists of the following:

1. Dieting. The expectant mother's diet should be rich in fruits and vegetables, and fermented milk products are healthy. Avoid the use of vinegar, spices, onions and garlic, spicy and pickled foods. It is necessary to temporarily limit the consumption of strong tea, coffee and quit smoking. To avoid swelling, it is advisable to reduce salt intake.
2. Compliance with drinking regime. A woman suffering from pyelonephritis should drink at least 3 liters of fluid per day. In addition to water, you can drink berry juices (cranberry, currant, lingonberry), and compotes.
3. For better outflow of urine from the infected kidney, a pregnant woman needs to sleep on her side; sleeping on her back is not recommended. Doctors advise taking the knee-elbow position and staying in it for up to 15 minutes several times a day.

If the course of the disease causes severe pain and occurs with complications, doctors prescribe treatment with antibiotics, the choice of which depends on the duration of pregnancy and the severity of the disease.

To treat pyelonephritis during pregnancy, antibiotic treatment is used:

• Ampicillin;
• Cephalosporins;
• Oxacillin;
• Gentamicin.

In addition to antibiotics, the doctor prescribes antispasmodics and, if necessary, painkillers. Many pregnant women become anxious and panic when they learn that the doctor has decided to use antibiotics for treatment. Expectant mothers should understand that the lack of antibiotic treatment, especially in severe forms of the disease, is much more dangerous for the fetus and poses a threat to the health and life of the baby. There are antibiotics that are approved in the early stages, but starting from the second half of pregnancy, the sensitivity of the fetus to certain groups of antibiotics decreases and their use is safe for the baby.

Folk remedies for pyelonephritis during pregnancy

Unconventional methods of treating any disease during pregnancy should be treated with particular caution. Pharmacies offer a wide range of medicinal herbs and preparations, the action of which is aimed at “washing out” the infection from the kidneys and relieving inflammation. These are bud herbs, bearberry, calamus, etc. Herbs are brewed with boiling water and filtered. Take 1 glass of decoction three times a day before meals, for a course of 2 months. Before taking renal preparations, you should consult with your doctor.

In addition to medicinal decoctions, you can brew compotes or fruit drinks from cranberries, lingonberries, sea buckthorn, which have an excellent diuretic effect, and also brew rose hips. You can drink healthy drinks throughout your pregnancy.

The most effective recipes for pyelonephritis

• Decoction of corn silk.
  Pour 1 tablespoon of corn silk with 1 glass of water and cook for 20 minutes. Leave the broth for half an hour and then strain. Take 2 tbsp tincture every three hours.
• Yarrow tincture.
  Pour 2 teaspoons of pharmaceutical herb into a glass of water and leave for 1 hour, strain. Take 3 tbsp 5 times a day.

Prevention of pyelonephritis during pregnancy

As you know, the best way to treat a disease is its prevention. To avoid infection and prevent kidney inflammation, a pregnant woman must adhere to the following rules:

1. Engage in moderate physical activity; daily walks in the fresh air are beneficial. By doing special gymnastics for pregnant women, you can strengthen your back muscles to improve the tone of your internal organs.
2. If a pregnant woman suffered from cystitis or pyelonephritis before conception, then from the first weeks of pregnancy it is important for her to follow a diet and drinking regime for better outflow of urine from the kidneys.
3. Empty your bladder at least every 3-4 hours, preventing harmful microorganisms from multiplying.
4. When planning a pregnancy, be sure to undergo a kidney examination for chronic pyelonephritis and treat existing diseases of the genitourinary system.
5. Pregnant women should not be overcooled, get cold feet and backs, and dress inappropriately for the weather.
6. Drink at least 1.5 liters of liquid per day, including vitamin juices and compotes.

A careful and careful attitude towards yourself and your health, and compliance with preventive measures will help prevent the development of dangerous kidney disease. If you were unable to avoid infection and discover symptoms of pyelonephritis, immediately seek medical help to begin treatment without delay.

Pyelonephritis in pregnant women occurs for various reasons, and this type of disease is called gestational. Pregnant women suffer from this disease due to problems in the urinary system, where an infection can first arise, which provokes the disease. Also, any inflammatory process in the body, be it a dental infection, stimulates gestation. The consequences of pyelonephritis during pregnancy may not be the best, but by following treatment they can be avoided.

Causes of pyelonephritis

• Difficulty urinating due to the growth of the uterus. It puts pressure on the bladder, thereby complicating its work.
• Hormonal changes.
• The disease of pyelonephritis, cystitis in childhood or before pregnancy flares up again.
• Reduced immunity, hypothermia and sedentary lifestyle.

Types of pyelonephritis

The manifestation of the disease is divided into two types:

• primary
• secondary

The primary disease occurs when urination changes. In this case, kidney disease is not observed.

The secondary disease of pyelonephritis is caused by inflammation of the urinary tract. Secondary pyelonephritis occurs in two phases:

• Acute pyelonephritis - flares up suddenly, symptoms manifest themselves within a few hours to a couple of days. With proper treatment, within three weeks, the patient recovers.
• Chronic pyelonephritis - manifests itself slowly, occurs due to bacteria that stimulate the process of inflammation. If an acute disease is not treated in a timely manner, the disease becomes chronic. The source of the chronic disease is non-functional kidney function and arterial hypertension.

The influence of pyelonephritis on the unborn child.

First of all, there is a high possibility of transmitting the disease to a child. The baby may have pathologies in the development of the heart and kidneys. The immune system becomes weakened; the consequences for the child will not be the best, which will lead to frequent colds.

Pyelonephritis in a pregnant woman develops oxygen deficiency in the fetus, which also interferes with the proper development of the baby’s organs. For this reason, children are born underweight and weak. Doctors also note more serious consequences of the disease:

• Damage to the central nervous system;
• Jaundice – lasting for a long time;
• The baby's body temperature is lower than required.

The effect of pyelonephritis on the fetus

It is very important to contact specialists for help in a timely manner. Timely treatment will lead to the salvation of both mother and fetus. Thus, in almost ninety percent of cases, it is possible to maintain a pregnancy that is complicated due to illness. If treatment is not followed, there is a danger to the fetus. Let us highlight the main consequences:

• Transmission, from mother to child, of an infectious disease;
• Fetal hypoxia;
• Inflammation of the baby’s important internal organs;
• Manifestation of conjunctivitis;
• Incorrect development of organs;
• Malnutrition of the fetus, as a result of the manifestation of gestosis in a pregnant woman, due to which the proper blood circulation of the brain, heart, kidneys, and placenta is disrupted.

Treatment of pyelonephritis

· Positional therapy;

· Drug treatment.

Positional therapy

You must follow simple rules of behavior:

· A pregnant woman should not sleep on her back, but prefer to sleep on her left side.

· At week 20, use the knee-elbow position, which will alleviate the condition of the pregnant woman. It is useful to carry out such an event several times a day, for fifteen minutes. For a visual example, view the photo at the link below.

· Drink a normal amount of fluid, up to three liters per day, if there are no contraindications. It can be: compote, jelly, water, but not tea or coffee.

· Do not consume urinary teas or herbs.

Drug treatment

During the first trimester, drug treatment is not recommended. During this period, the formation of the baby’s main internal organs occurs. If there are slight changes in urine tests, you should adhere to the above tips. The approach to antibiotics is different; they are used in cases of high fever, when inflammation actively manifests itself. It is allowed to use penicillin for treatment.

In the second trimester, the variety of antibiotics is more extensive, these are:

• Furadonin;
• cephalosporin category II and III.

And also a group of macrolides:

• azithromycin;
• furadonin;
• erythromycin.

Contraindicated for use during pregnancy:

• Biseptol;
• Tetracycline;
• Levomycin;
• Fluoroquinolone.

Pyelonephritis is a common illness during pregnancy, which carries with it complex consequences. But it is necessary to follow the doctor’s instructions, even if it means frequent tests, repeated examinations by the doctor, but this is for the benefit of you and your child.

Video on the topic of the article:

Pregnancy is an important stage in the life of every woman, which lasts 9 months and ends with the birth of a long-awaited baby. Unfortunately, bearing offspring also serves as a stress factor for the body, as a result of which many chronic diseases that are dormant are exacerbated. The first signs of pyelonephritis during pregnancy are not known to everyone: this explains the low appeal to a specialist. To protect yourself and your baby from possible complications and negative consequences, you need to undergo regular tests and monitor your health throughout your pregnancy.

What is pyelonephritis during pregnancy?

Pyelonephritis is an inflammatory disease of the renal pyelocaliceal apparatus, which is caused by bacteria and can occur at any stage of pregnancy. The disease can be both acute (newly occurring and lasting from two to five days) and chronic (with constantly alternating phases of exacerbation and remission). The main triad of symptoms consists of increased blood pressure, lower back pain and the appearance of protein with bloody impurities in the urine.

Knowledge of the anatomy of the kidneys will help to understand the causes of pyelonephritis.

A normal kidney consists of several small cups united into larger pelvises, from which urine is directed through the ureter to the bladder. This structure provides better filtration of all fluid in the body. During pregnancy, the enlarged uterus puts slight pressure on the organs of the urinary system, thus causing congestion. This creates optimal conditions for the growth and development of pathogenic microflora.

Causes of the disease

Pyelonephritis is a disease that is caused primarily by bacterial pathogens. The most frequently encountered representatives include:

• staphylococcus;
• streptococcus;
• Proteus;
• Pseudomonas aeruginosa;
• Klebsiella;
• coli;
• enterococcus;
• some types of protozoa.

And it is also necessary to take into account external and internal factors that increase the risk of developing inflammatory processes in the body. This:

• recent operations;
• traumatic injuries of the abdominal organs and retroperitoneal space;
• sedentary lifestyle;
• frequent changes in climate zones;
• the presence of chronic diseases (HIV, hepatitis, syphilis, tuberculosis, diabetes mellitus, hypertension, endocrine pathologies);
• abnormalities in the development of the genitourinary system (absence of the ureter, double kidneys, underdevelopment of the bladder);
• reverse reflux of urine into the pyelocaliceal system;
• unprotected sexual intercourse with a large number of sexual partners;
• violation of the rules of sanitary culture and personal hygiene;
• low awareness of one's own health.

The causative agent of pyelonephritis enters the body of women in three ways: through the blood, lymphatic fluid and urethra. The first type of transmission is most common, and the source of infection can be located in any part of the body.

For example, untreated caries or a festering scratch can become a direct cause of the development of pyelonephritis.

After penetration into the human body, the bacterium settles in the lymph nodes, where its first cycle of reproduction begins, which ends with migration into the bloodstream. With the flow of fluid, it reaches the renal system, affecting the pelvis and calyces. At this point, active processes of cell damage and death begin, which is accompanied by swelling of the organ, causing the first pain syndrome. The kidneys perform their function much worse, swelling and signs of uremic intoxication of the body develop: nausea, vomiting, general weakness and sleep disturbances. At a later stage, connective tissue grows in place of dead cells - this is how acute or chronic renal failure develops, which can cause the death of the patient and the fetus.

Symptomatic manifestations of pyelonephritis during pregnancy

All general and local signs of pyelonephritis quite often add up to a picture that allows one to suspect a diagnosis. The typical form of the disease begins with intoxication, which is then accompanied by symptoms of renal damage, but in cases of complicated pyelonephritis, everything can be completely opposite.

In his clinical practice, the author of this article came across a case where a pregnant woman complained of the child’s hyperactivity during the urination process. The baby began to kick strongly, causing significant discomfort. This forced the girl to visit a doctor, as a result of which she was diagnosed with bilateral pyelonephritis.

Lower back pain is a common symptom of pyelonephritis

Local manifestations of the disease include:

• nagging pain in the lumbar region;
• redness and cloudiness of urine, the appearance of clots and foreign impurities in it;
• urination disorders: urine retention, pain, burning and itching, urine droplets;
• increased blood pressure;
• the appearance of swelling in the facial area.

Swelling of the face indicates the accumulation of fluid in the body

Generalized signs of kidney inflammation:

• weakness, lethargy, severe fatigue;
• headaches and dizziness;
• appetite disorders;
• poor sleep;
• temperature increase;
• apathy and depression;
• irritability;
• fatigue in the evening;
• decreased performance;
• low endurance.

Table: characteristics of symptoms of pyelonephritis at different stages of pregnancy

Comparative clinical sign	First trimester (weeks 1–13)	Second trimester (weeks 14–27)	Third trimester (28 to 40 weeks)
Temperature increase	up to 37–38 degrees	38–39 degrees	up to 40 degrees
The appearance of protein and blood in the urine	up to 1 gram per liter	1–3 grams per liter	more than 3 grams per liter
A rise in blood pressure above normal by 20–30 mmHg	practically uncharacteristic	occurs in 40–60% of all patients	the majority of patients (up to 90%) suffer from hypertensive crises and periodic loss of consciousness
Urinary disorders	inability to completely empty the bladder, feeling of fullness	discomfort during urination associated with impaired urine flow	false urges, itching and burning in the urethra
Pain syndrome	localized in the kidney area, increases with stress and physical activity	in the umbilical region with a return to the groin and upper thigh	felt evenly over the entire surface of the back below the edge of the shoulder blades, may radiate to the navel

Diagnosis methods

The first doctor a woman will turn to with her complaints is an obstetrician-gynecologist. He subsequently redirects the patient to a nephrologist. The specialist begins work with farrowing: the patient is required to describe in as much detail as possible the time when the first symptoms appeared and their characteristics, and describe the previous treatment. If the disease existed before pregnancy, it is necessary to clarify the timing of the last exacerbation and its duration.

It is believed that the tendency to develop kidney diseases is inherited. Women whose immediate family members have suffered from pyelonephritis are twenty percent more likely to develop the condition.

After finishing the conversation and clarifying the main complaints, the doctor proceeds to the examination. The pregnant woman is asked to undress to the waist and is carefully examined. The development of inflammatory pathology in the body is indicated by:

• pallor and dryness of the skin and mucous membranes;
• seizures in the mouth area;
• bruises under the eyes;
• swelling of the neck and face;
• whitish coating on the tongue.

Another specific method for diagnosing pyelonephritis is checking Pasternatsky’s symptom. To do this, the doctor places the palm of one hand on the lower edge of the costal arch on the back, and then strikes it with the fist of the other hand. With the development of the inflammatory process in the kidneys, the pain intensifies and migrates in the opposite direction.

What diseases are most often confused with?

Pyelonephritis is a fairly common disease from the group of renal pathologies that occur in most of the population. They have extremely similar clinical symptoms, which makes diagnosis much more difficult. Many patients unconsciously ignore their complaints or seek help from a completely different specialist who cannot correctly understand and read the clinical signs.

Most often, pyelonephritis in pregnant women is differentiated with the following ailments:

• cystitis;
• urethritis;
• glomerulonephritis;
• kidney cyst;
• malignant and benign diseases of the pelvic organs and retroperitoneal space;
• ectopic pregnancy;
• miscarriage;
• symptomatic arterial hypertension and hypertension;
• eclampsia and preeclampsia;
• diabetic, paraneoplastic, toxic, drug-induced, alcoholic nephropathy;
• overdose of medications or drugs;
• tuberculosis of the genitourinary system;
• urolithiasis.

Laboratory tests for pyelonephritis

To obtain as much information as possible about the health status of a pregnant woman, it is necessary to regularly evaluate all tests. To do this, blood is donated and several types of urine tests are taken. After a couple of days, the doctor receives all the results, based on which it can be concluded that the pyelocaliceal system is damaged.

Blood in the urine is a serious sign of the development of the disease

Most often prescribed:

1. A complete blood count is a standard screening test that is performed on all patients entering the clinic for further examination. With pyelonephritis, pronounced inflammatory changes are observed: an increase in leukocytes, lymphocytes, neutrophils, macrophages, erythrocyte sedimentation rate and C-reactive protein. Anemia with low hemoglobin and platelets may also occur.
2. Urinalysis according to Nechiporenko is carried out when examining the first morning portion of urine. It is thoroughly mixed with a glass rod and placed in special chambers, where the same cellular elements are counted under a microscope. During pyelonephritis, there is always an increase in leukocytes from two thousand, red blood cells - more than a thousand, and cylinders - more than twenty units.
3. A general analysis of urine evaluates primarily physical properties. Normal urine has a straw-yellow color, moderate density and transparency. The inflammatory process is manifested by the appearance of blood or even clots, cloudiness of urine, and the formation of a crystalline sediment. It is also possible to detect the presence of pathogenic microorganisms in this way.
4. Bacteriological culture of urine. After microscopy of the urine sediment, it is transferred to various nutrient media using a cotton swab. After a few days, the level of bacterial growth is assessed. This makes it possible to discover which pathogen is causing the infection, as well as select specific treatment.

Instrumental studies for the disease

Thanks to the achievements of modern medicine, it becomes possible to assess the condition of the kidneys without resorting to invasive surgical methods. Instrumental examination methods cannot replace laboratory ones, but are an excellent addition to confirming the diagnosis of pyelonephritis. Unfortunately, their use during pregnancy is also limited. The most commonly used methods are:

The main methods of treating pyelonephritis during pregnancy

Treatment of inflammatory diseases in the pelvicalyceal system is a rather lengthy and labor-intensive process, which is largely complicated by the fact that most standard medications are prohibited from being taken during pregnancy. Strong emphasis is placed on traditional medicine and herbal medicine. Changing your eating style and drinking regime also has a beneficial effect on a woman’s health.

Important principles of treatment for pyelonephritis during pregnancy:

• reduction of pain syndrome;
• normalization of blood pressure;
• stimulation of immune system cell activity;
• removing excess fluid from the body;
• restoration of water-salt and acid-base balance;
• no negative effect on the fetus;
• destruction of the bacterial pathogen that provoked the infection.

Medications to treat illness

During pregnancy, the mother's body perceives many substances as foreign components. They can also seriously affect the development of a small person, disrupting the maturation of his organs and tissues. Most often, the nervous, endocrine, and respiratory systems suffer from the use of medications, and external deformities and deformations of the facial skull also appear.

In the practice of the author of this article, there were clinical cases where women independently prescribed and discontinued antimicrobial drugs. Unfortunately, in the vast majority of cases, children were born with serious impairments of hearing, vision, and smell; there was a deep cleft palate or non-closure of holes in the atrial septum, which led to disruption of normal blood flow.

The best way to combat the causative agents of pyelonephritis are antibiotics: they kill pathogenic microflora, preventing further reproduction and development of the microbe in the body's cells. When using these groups of drugs there is no toxic effect on the baby:

1. Penicillinins: Benzylpenicillin sodium and potassium salt, Bicillin-1, Bicillin-5, Oxacillin, Ampicillin, Ampiox, Flemoxin, Dicloxacillin, Azlocillin.
2. Cephalosporins: Cephalexin, Cefazolin, Cefaclor, Cefuroxime, Cefpirome, Cefepime, Cephobid, Rocefin, Fortum, Claforan, Ceclor, Vercef, Keflex, Zinnat, Zinacef.
3. Macrolides: Erythromycin, Roxithromycin, Clarithromycin, Midecamycin, Macropen, Klacid, Rulide, Oleandomycin phosphate, Lincomycin.

Other groups of drugs used to treat the disease:

1. Herbal remedies that gently remove excess fluid, toxins and waste from the body. These include Canephron, Cyston, Phytolysin, and pharmaceutically prepared kidney preparations.
2. Antihypertensive drugs are used to reduce arterial hypertension and reduce blood pressure to normal levels. In obstetrics and gynecology, Verapamil, Diltiazem, Labetalol, Norvasc, Captopril, Enalapril are used.
3. Stimulants of the immune system help activate the body's internal reserves and direct the forces of cells to fight the infectious agent. The most commonly used are Timalin, Timogen, Taktivin, Cycloferon and human immunoglobulin preparations.
4. Diuretics should include Urea, Mannitol, Triamterene, Indapamide, as well as any mineral waters and fruit and vegetable juices.

Photo gallery: antibiotics and other drugs used to treat pyelonephritis

Ampicillin is well tolerated during pregnancy Ceftriaxone must be dissolved in novocaine Erythromycin helps remove microorganisms Canephron has anti-inflammatory, antispasmodic, antiseptic and diuretic effects
Captopril is used to treat arterial hypertension. Indapamide removes excess water from the body and lowers blood pressure.

The nutritional culture of pregnant women is a separate science, the basics of which must be learned at school for expectant mothers. It is worth noting that if the renal pyelocaliceal system is inflamed, you will have to give up your usual eating style. All dishes must be baked, boiled or stewed: fried, smoked and dried delicacies must be excluded from the diet. The number of meals during the day is at least five: breakfast, lunch, dinner, several hearty and healthy snacks. It is also necessary to maintain a drinking regime, drinking at least two liters of clean water per day.

Possible breakfast options:

• porridge with water or milk (rice, oatmeal, rolled oatmeal, buckwheat, millet) with the addition of berries, honey or nuts;
• cottage cheese of at least five percent fat content with sour cream;
• plain yogurt and bread with cheese and butter.

• soup (pea, chicken, mushroom, solyanka, borscht, cabbage soup, cream, cheese, puree) with several slices of whole grain bread;
• stewed vegetables in their own juice;
• fish, meat plate.

What to eat for dinner:

• durum pasta with goulash;
• boiled potatoes with chicken breast;
• baked vegetables or turkey stew;
• salmon with buckwheat porridge.

• yogurt, cottage cheese, kefir, fermented baked milk;
• fresh fruits;
• nuts;
• muesli;
• bitter chocolate.

What is strictly prohibited to consume during pyelonephritis:

• chips, crackers;
• fast food;
• carbonated drinks;
• any alcohol;
• semi-finished products;
• custard noodles;
• industrial sweets;
• black coffee.

Fast food is bad for your metabolism Coffee increases your blood pressure Chips contain a lot of salt

Traditional medicine as an aid

It has long been known that natural recipes are used by women all over the world in order to alleviate their current condition and not harm the baby. Many people deliberately refuse to take traditional medications, completely replacing them with various teas and decoctions. This behavior is not correct, since all traditional medicine helps only to get rid of clinical symptoms, but is practically unable to affect the life cycle of the bacterium that causes pyelonephritis.

The main advantages of natural remedies:

• cheapness;
• ease of preparation and use;
• the ability to assemble the ingredients yourself;
• minimal harm to the health of mother and child;
• good effect from use.

The disadvantages include:

• the possibility of allergic reactions;
• individual intolerance during pregnancy;
• rapid loss of effect upon cessation of use.

Traditional medicine recipes that help cope with the manifestations of pyelonephritis during pregnancy:

1. Take three large carrots and two beets and use a juicer to make juice. Dilute 200 ml of juice with 100 ml of hot water and drink on an empty stomach. Beets and carrots not only contain a large amount of vitamins, but also have a pronounced stimulating effect on the immune system of the human body, forcing it to fight bacteria. This juice must be consumed within two months.
2. Brew three sachets of chamomile in a half-liter mug of boiling water. After cooling, drink the solution in small sips. The procedure is best carried out at a time when you do not plan to be away from home for a long time: chamomile has a mild diuretic effect, removes harmful toxic substances and waste from the body.
3. Place 200 grams of crushed burdock leaves in a saucepan with a liter of hot water and cook over low heat, stirring clockwise. Once the liquid has cooled, divide it into three equal portions to drink throughout the day. Burdock leaves do an excellent job of treating inflammatory processes.

Photo gallery: traditional medicine for pyelonephritis

Beets and carrots contain many beneficial substances Chamomile stimulates urination Burdock relieves inflammation

Video: competent therapy for kidney inflammation during pregnancy

Prognosis and possible complications of the disease

Pyelonephritis is a rather serious infectious disease, the improper treatment of which negatively affects the health of both mother and child. This is why most pregnant women are treated in a hospital setting rather than at home. This makes it possible to reduce the percentage of maternal and infant mortality by two to three times.

If necessary, patients are issued sick leave for up to fifteen days. The decision to extend it is made by a medical commission.

Disability is assigned only to patients with chronic pyelonephritis that has existed for a long time. The first group is for people with severe renal failure who cannot exist without monthly dialysis procedures - blood purification using special devices. In this case, pregnancy is out of the question. The second disability group is assigned to chronic pyelonephritis with frequent exacerbations and complications, as well as the initial form of kidney failure. Pregnancy usually ends with a caesarean section. Persons included in the third group experience periodic urination problems and can give birth on their own.

Possible complications of pyelonephritis in pregnant women:

• acute or chronic kidney failure;
• gestosis and toxicosis;
• peripheral circulatory disorders;
• thrombosis and thromboembolism of the great vessels;
• infectious-toxic shock and development of sepsis;
• premature birth, early miscarriage, stillbirth;
• intrauterine infection of the fetus;
• abnormalities in the formation of the nervous, cardiovascular, respiratory and endocrine systems in an infant;
• death of a child in late and early stages.

Prevention of pyelonephritis during pregnancy

During the period of bearing a baby, a woman is especially vulnerable and susceptible to the influence of various pathogenic microflora. Any hypothermia, prolonged exposure to the cold, or an accidentally contracted infection can cause the development of pyelonephritis. Unfortunately, most environmental factors have a significant impact on the body, and it is not possible to completely remove them. However, a system of preventive measures aimed at protecting women's health is currently widely used.

In his practical activities, the author of this article has repeatedly encountered various stages and types of pyelonephritis in pregnant women. After treatment, all patients were prescribed specific prophylaxis and given some recommendations for correcting their usual lifestyle. Those who were able to give up bad habits and change their eating style did not experience relapses of pyelonephritis. In others, on the contrary, the course of the disease was complicated by the formation of stones in the kidneys and ureters.

1. Give up bad habits. Alcohol, nicotine and drugs used during pregnancy not only cause delays in fetal development and the risk of premature birth, but also cause a serious blow to the health of the entire body. Cigarette smoke causes spasms of the blood vessels responsible for feeding the kidneys, and the ethyl alcohol contained in alcohol disrupts the formation of healthy cells.
   It is unacceptable to drink alcohol during pregnancy
2. Maintain good hygiene. It is known that in the area of ​​the vagina, urethra and anus there are a huge number of pathogenic microorganisms that can be carried back into the renal pelvis with urine flow. This is why it is so important to take a morning and evening shower or bath every day, use thin pads for discharge and change bed and underwear. Remember that ordinary gels and shampoos are not suitable for intimate hygiene and can disrupt the vaginal microflora, causing dysbacteriosis. It is recommended to purchase special soap at the pharmacy for these purposes.
3. Attend gymnastics for pregnant women. Many women believe that waiting for childbirth is a process during which you can relax as much as possible and not maintain the desired physical shape. However, exercise not only has a tonic effect on the muscles, but also helps reduce venous and arterial congestion in the pelvic area. You can practice both at home and in group training with a master. An additional advantage to general physical education will be exercise with a fitball: it also helps to better prepare for the upcoming birth.
   Gymnastics helps keep the body in good shape
4. Always dress appropriately for the weather. Pregnant women are much more susceptible to developing colds and viral diseases that attack the body during hypothermia. If you spend a lot of time outdoors, choose long down jackets or fur coats, warm jackets and sweaters made of natural wool.
5. Treat existing purulent-inflammatory diseases before planning pregnancy. As mentioned earlier, the source of bacterial microflora in pyelonephritis can be caries, carbuncle, boil, or even an old scratch. Doctors strongly recommend undergoing a full medical examination to identify and eliminate such ailments. If necessary, the woman is prescribed antibacterial therapy for up to two weeks. After all the activities have been completed, you can safely begin planning your pregnancy.
   Treatment of caries must be carried out before pregnancy
6. Take the necessary tests and participate in screenings. It is believed that a system of regular blood and urine testing will identify even the earliest stages of pyelonephritis. It is necessary to register with the antenatal clinic at your clinic within a period of up to twelve weeks. If you become ill with pyelonephritis in the later stages, the first thing you should do is notify your doctor.