Pregnancy Risk Factors: Pyelonephritis

Causes, symptoms, treatment and prevention of kidney infections
during pregnancy

Pregnancy is a time in a woman's life when her body is undergoing significant changes. While these changes are necessary and important to support a growing baby, they also increase the likelihood of certain conditions, such as pyelonephritis, which can lead to serious health complications.

Pregnancy-related pyelonephritis (also known as a kidney infection) is a potentially life-threatening condition caused by bacteria that infect the kidney. It typically begins as an infection in the lower urinary tract but can spread to the bladder and kidneys if left untreated.

How common is pyelonephritis during pregnancy?

According to a study published in the National Library of Medicine, pyelonephritis affects about 1 to 2 percent of pregnancies. However, 20 to 30 percent of women who get pyelonephritis during pregnancy will experience preterm labor, which can lead to serious health risks for babies.

Causes of pyelonephritis

Pyelonephritis is more common in women who are pregnant because pregnancy can lead to changes that make women more susceptible to infection, including increased progesterone levels and increased pressure on the ureters (the ducts that pass urine from the kidneys to the bladder) as the uterus expands.

Pyelonephritis occurs more often in pregnant women with diabetes or urinary tract infections. Other women with an increased risk of pyelonephritis include those who:

  • Are Immunosuppressed

  • Have a history of recurring urinary tract infections

  • Have sickle cell anemia

  • Have neurogenic bladder

  • Smoke

  • Don’t receive adequate prenatal care

Pyelonephritis can occur any time during pregnancy, but it’s more common in the 2nd and 3rd trimesters. The condition is also more common in women who are pregnant with twins or triplets.

Because urinary tract infections during pregnancy are most likely to develop during the 2nd or 3rd trimester, your OB-GYN will collect urine samples during your prenatal appointments to screen for bacteria.

kindney ultrasound

Symptoms of pyelonephritis

The first signs of pyelonephritis are typically fever, chills and flank pain (pain on both sides of the lower back).

Other symptoms include:

  • Nausea

  • Vomiting

  • Urinary frequency or urgency
  • A burning sensation during urination

  • Blood in the urine

These symptoms usually develop quickly and will worsen over time if left untreated. If you’re experiencing any of these symptoms, your OB-GYN will likely order a urine culture to confirm a pyelonephritis diagnosis.

They will also need to rule out other conditions with similar symptoms, such as a urinary tract infection or kidney stones.

Complications of pyelonephritis

Pyelonephritis can lead to kidney damage, respiratory distress and anemia. If left untreated, pyelonephritis can also cause sepsis, a potentially life-threatening condition. Sepsis occurs when an infection spreads through the bloodstream and can lead to organ failure and death.

Additionally, pyelonephritis can lead to preterm labor, which puts babies at an increased risk of health complications such as low birth weight and respiratory distress if they’re born prematurely.

How is pyelonephritis treated?

If you experience flank pain, fever, chills, or any symptoms related to a urinary tract infection during pregnancy, it’s essential to see a doctor immediately. These symptoms could be signs of pyelonephritis. Early treatment is vital to prevent complications, including preterm labor.

Most women who are diagnosed with pyelonephritis will need to be monitored and given IV antibiotics for at least 48 hours in a hospital setting. Your doctor will want to ensure that you’re fever free and have a negative urine culture (indicating you no longer have a bacterial infection) before discharging you from the hospital.

If the initial course of antibiotics is not effective after 48 hours, different antibiotics may need to be administered. Patients may also need to continue taking oral antibiotics at home for up to 2 weeks after they’re discharged from the hospital.

Ways to prevent pyelonephritis

There are several steps you can take to help prevent pyelonephritis during pregnancy. They include:

  • Drink plenty of fluids.

  • Wipe from front to back after using the bathroom.

  • Practice good hygiene.

  • Wear loose-fitting clothing.

  • Wear cotton underwear.
  • Avoid douching.

  • Empty your bladder often and immediately before and after sexual intercourse.

  • Treat urinary tract infections early, and finish any antibiotics prescribed to treat the infection.

  • Attend all prenatal appointments.

Women with a history of urinary tract infections may also require closer monitoring, more frequent urine screenings, and the use of prophylactic antibiotics. Regardless of your history, it’s vital that every pregnant woman receives regular prenatal care so urinary tract infections can be detected and treated early—before they lead to pyelonephritis.

By taking these steps, women can help protect themselves and their babies from the potentially severe complications of pyelonephritis.

What should I do if I’m concerned about pyelonephritis during pregnancy?

If you’re concerned about developing pyelonephritis during pregnancy or you have any signs of a urinary tract infection while pregnant, you should talk to your doctor immediately. When caught early, measures can be taken to prevent bacteria in the urine from infecting your kidneys and causing pyelonephritis.

In addition to notifying your doctor if you experience symptoms, it’s crucial that you attend all regularly scheduled prenatal appointments so your OB-GYN can monitor the health of you and your baby and order additional screening and tests if necessary.

At All About Women Obstetrics & Gynecology, our compassionate OB-GYNs have been helping mothers in Gainesville and Lake City bring healthy babies into the world for more than 20 years. Our patient-centered practice is focused on providing you and your baby with the best prenatal care to suit your unique needs. Contact us today to schedule your appointment.