So, pyelonephritis. Inflammatory kidney disease.
- It occurs quite often (urinary tract infections, according to statistics, take second place after acute respiratory viral infections in the structure of the incidence of infectious diseases)
- Prefers women (women get sick 8 times more often than men).
This is due to the anatomy of the female urogenital organs: a short urethra is located next to the vagina, which makes it possible to quickly penetrate and spread the infection.
Men suffer from pyelonephritis in old age, when prostate hypertrophy develops and urodynamics are significantly impaired.
- Among women, she especially “loves” pregnant women (pyelonephritis during pregnancy is 6-12% of the total incidence).
Pyelonephritis and pregnancy often go hand in hand.
Pyelonephritis during pregnancy: causes
There are several causes of pyelonephritis that developed during pregnancy (“gestational pyelonephritis”).
1 Changes in the ureters: they are elongated, lose their tone, they are compressed by ovarian veins, dilated under the influence of hormones (the right ovarian vein often suffers due to its anatomical location, respectively, during pregnancy, pyelonephritis of the right kidney occurs more often, although bilateral damage also occurs) and growing pregnant uterus (exacerbates the process by the presence of a narrow pelvis, large fetus or multiple pregnancy).
2 Stagnant urine and, as a result, the renal pelvis stretches up to hydronephrosis.
3 Reproduction of bacteria (especially Escherichia coli) on the background of reduced immunity, which often happens during pregnancy, under the influence of estrogen produced by the placenta.
With pyelonephritis, there is no specific pathogen. A variety of pathogenic flora is often sown: Escherichia coli and Pseudomonas aeruginosa, Proteus, Klebsiella, enterococci, streptococci, staphylococci are somewhat less common. There are cases of detection of protozoa (trichomonads), viruses, fungi, and sometimes microbial associations as a source of infection.
Kidney tissue infection occurs in an ascending way. Through the blood, microbes can penetrate the kidneys from other foci of infection (for example, from the oral cavity with stomatitis, caries or ENT diseases).
At risk are women who have had cystitis or pyelonephritis before.
Hypothermia, hypodynamia, hypovitaminosis also contribute to the development of pyelonephritis during pregnancy.
Features of the treatment of pyelonephritis during pregnancy
The treatment of pyelonephritis during pregnancy has several features.
First of all, you need to adhere to certain rules:
Eliminate hypothermia, nervous stress, severe physical exertion, observe bed rest from the first days of treatment. Moreover, it is necessary to be treated in a hospital under the supervision of an obstetrician-gynecologist, therapist and, if necessary, a nephrologist to avoid complications. This is the so-called "positional treatment", which begins with a unilateral lesion. In order to restore the outflow of urine, you need to occupy the knee-elbow position on the side opposite to the diseased kidney. The legs should be above the head end of the body. Thus, the pressure of the uterus on the diseased ureter and kidney is reduced, and an improvement in the outflow of urine along the compressed ureter is ensured. If the situation does not improve during the day, the issue of catheterization is considered.
Bed rest - a prerequisite from the first days of the disease, because the clinic is pronounced and is accompanied by intense pain, fever, chills, significant bacteriuria, impaired urination, sometimes nausea and vomiting. Failure to comply with bed rest can lead to serious complications up to termination of pregnancy.
Prescription of medicines with pyelonephritis is a necessary condition for treatment. They begin to take them from the first day to prevent complications.
Several groups of drugs are used: antibiotics, uroantiseptics, antispasmodics, if necessary - painkillers and sedatives, depending on the severity of the condition and the data from the examinations.
There are some features of prescribing drugs. Given that pyelonephritis develops in the presence of pregnancy, the main requirement is not only effectiveness, but also safety for the fetus.
All treatment takes place individually, depending on the severity of the condition, the extent of the clinic, and the duration of pregnancy.
In the first trimester of pregnancy the formation of the fetus, the laying of organs. The placenta has not yet formed and does not fulfill its protective functions. Antibiotics at these times are prescribed exclusively in case of emergency and with caution. You can use drugs of the penicillin group (Ampicillin, Oxacillin, Amoxicillin, Amoxiclav).
In the second trimester groups of drugs for treatment are expanding. Suppose the reception of cephalosporins of the second and third generations (suprax, ceftriaxone, cefazolin), you can take furadonin. Limitations of admission - no later than the 36th week of pregnancy, the duration of treatment - from five to ten days.
From the fourth month of pregnancy if necessary, 5-NOC (nitroxoline) is prescribed.
Relatively safe is the macrolide group (Sumamed), erythromycin, but they are active only against staphylococcus. Most pathogens of pyelonephritis are resistant to them.
There are categorical contraindications for certain drugs and groups of drugs at any stage of pregnancy. These include fluoroquinolones (nolicin, ciprofloxacin), tetracyclines, biseptol and chloramphenicol. You need to know about this, and never self-medicate, since the risk of complications is very high. Even in a medical institution during hospitalization, drugs are prescribed only after certain examinations (including bacterial seeding) in order to identify a specific pathogen and its sensitivity to a specific antibiotic.
Pyelonephritis during pregnancy: is it possible to treat folk remedies
As an addition to the main treatment, which is carried out under the supervision of specialists in the hospital, you can use certain folk remedies. Phytotherapy is coming into play. The purpose of this treatment method is to improve the outflow of urine, reduce inflammation. This means that plants with anti-inflammatory and diuretic (diuretic) effects are used.
But herbal treatment of pyelonephritis, which developed during pregnancy, also has a number of features. It is necessary to remember the list of herbs that are prohibited for use in pregnant women, but successfully treat pyelonephritis, due to its various properties, outside of pregnancy. These include the well-known bearberry, fruits of juniper, parsley, yarrow, licorice.
It would seem that such a harmless and accessible to everyone method of herbal treatment also requires special care and knowledge. Self-medication is unacceptable.
One of the tasks of using folk remedies, as discussed above, is to increase the outflow of urine from the kidneys, that is, their "washing". For this, it is necessary to take a sufficient amount of liquid (about two liters per day), provided there is no edema. You can use a variety of teas with birch leaves, nettles, cranberry fruit drinks and lingonberries. It is safe for pregnant women and effectively complements drug treatment.
A unique treatment is oats. The possibilities are endless! But you need to use cereals, not cereals. A decoction is prepared, filtered and taken several times a day on an empty stomach, one hundred milliliters (half a glass). The preparation of the broth is as follows: on a small fire for two to three hours, you need to boil the cereal in proportion to water 1: 1 (a glass of oats per liter of water). In this case, the volume of liquid becomes less than half. You have to stock up on time and patience, but the result is worth it!
Oat broth has universal properties and the widest spectrum of effects on many organs and systems. Pyelonephritis during pregnancy is a direct indication for its use: oats, unlike many other plants, reduces ureter hypotension, does not increase uterine tone. It has an anti-inflammatory effect, which is very important in the treatment. And its main distinguishing feature is the formation of mucus, which improves stool and helps prevent constipation. This is invaluable during pregnancy, as often many women who lead a sedentary lifestyle for various reasons suffer from this. So oats can be considered a real find for the treatment of pyelonephritis during pregnancy!
Sometimes the general condition, well-being and mood are such that there is no desire to independently make herbs. There is an exit. There is a ready-made combination of herbs, approved for use in pyelonephritis in pregnant women. Such is the official drug "Kanefron". Its composition includes centaury, lovage and rosemary. Due to the properties of these plants, it has anti-inflammatory, antimicrobial, antispasmodic and mild diuretic effects.
Thus, the treatment of pyelonephritis during pregnancy should be timely, in full and using all necessary and affordable methods. Self-medication or inaction should not be allowed, as this threatens with numerous complications for both the pregnant woman and the fetus.
Pyelonephritis during pregnancy: prognosis for childbirth
The most common complications of pyelonephritis during pregnancy include late toxicosis, spontaneous abortion in the early or late stages, premature birth, fetal death, the development of severe anemia.
In addition, a newborn baby may also suffer from infection. Pathology in a child. born of a mother suffering from pyelonephritis during pregnancy can be of varying severity. Conjunctivitis is often found as the easiest option for complications. But serious injuries of internal organs (lungs, kidneys, etc.) are not ruled out.
It is important to know that during pregnancy with any infectious disease, including pyelonephritis, fetal hypoxia occurs. This leads to malnutrition, underdevelopment of muscle mass. Such a newborn will often get sick, lag behind in the overall development.
In this regard, you need to protect your health and monitor your well-being, given that pyelonephritis can be asymptomatic in some cases. And if you miss some of its symptoms, which are expressed slightly, and do not start treatment on time, the consequences will be sad.
That is why during pregnancy you need to lead the most active motor lifestyle, follow a certain diet, which does not require much effort, but will ultimately reward a good result.
Pyelonephritis during pregnancy: prevention of complications, diet
First of all, you must refrain from salty, spicy and fried foods. This will be the prevention of another unpleasant effect of pyelonephritis during pregnancy, which develops quite often: arterial hypertension, eclampsia or preeclampsia of pregnant women.
Well, of course, you can not do without the traditional use of watermelon, melon, pumpkin, which must be consumed in large quantities, if there is such a possibility. They have an excellent diuretic effect, and in themselves are already ready-made therapeutic agents that improve the outflow of urine from the kidneys and prevent the development of edema.
It is necessary to urinate as often as possible - this helps to wash the kidneys and is another way to prevent urinary stagnation. And in any life circumstances, do not forget about walking, maximum physical activity, while avoiding hypothermia.
Take care of yourself and stay full of strength and health!
