Pyelonephritis During Pregnancy – What are the causes?

This condition is caused by a bacterial infection in the lower urinary tract that spreads to the kidney.

What increases the risk?

You are more likely to develop this condition if:

• You have diabetes.
• You have a history of frequent urinary tract infections.

What are the signs or symptoms?

Symptoms of this condition may begin with symptoms of a lower urinary tract infection. These may include:

• A frequent urge to pass urine.
• Burning pain when passing urine.
• Pain and pressure in your lower abdomen.
• Blood in your urine.
• Cloudy or smelly urine.

As the infection spreads to your kidney, you may have these symptoms:

• Fever.
• Chills.
• Pain and tenderness in your upper abdomen or in your back and sides (flank pain). Flank pain often affects one side of the body, usually the right side.
• Nausea, vomiting, or loss of appetite.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.
• Tests to confirm the diagnosis. These may include:
  • Blood tests to check kidney function and look for signs of infection.
  • Urine tests to check for signs of infection, including bacteria, white or red blood cells, and protein.
  • Tests to grow and identify the type of bacteria that is causing the infection (urine culture).
  • Imaging studies of your kidneys to learn more about your condition.

How is this treated?

This condition is treated in the hospital with antibiotics that are given into one of your veins through an IV. Your health care provider:

• Will start you on an antibiotic that is effective against common urinary tract infections.
• May switch to another antibiotic if the results of your urine culture show that your infection is caused by different bacteria.
• Will be careful to choose antibiotics that are the safest during pregnancy.

Other treatments may include:

• IV fluids if you are nauseous and not able to drink fluids.
• Pain and fever medicines.
• Medicines for nausea and vomiting.

You will be able to go home when your infection is under control. To prevent another infection, you may need to continue taking antibiotics by mouth until your baby is born.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Continue to take your prenatal vitamins.

Lifestyle

• Follow instructions from your health care provider about eating or drinking restrictions. You may need to avoid:
  • Foods and drinks with added sugar.
  • Caffeine and fruit juice.
• Drink enough fluid to keep your urine pale yellow.
• Go to the bathroom frequently. Do not hold your urine. Try to empty your bladder completely.
• Change your underwear every day. Wear all-cotton underwear. Do not wear tight underwear or pants.

General instructions

• Take these steps to lower the risk of bacteria getting into your urinary tract:
  • Use liquid soap instead of bar soap when showering or bathing. Bacteria can grow on bar soap.
  • When you wash yourself, clean the urethra opening first. Use a washcloth to clean the area between your vagina and anus. Pat the area dry with a clean towel.
  • Wash your hands before and after you go to the bathroom.
  • Wipe yourself from front to back after going to the bathroom.
  • Do not use douches, perfumed soap, creams, or powders.
  • Do not soak in a bath for more than 30 minutes.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have chills or a fever.
• You have any symptoms of infection that do not get better at home.
• Symptoms of infection come back.
• You have a reaction or side effects from your antibiotic.

Get help right away if:

• You start having contractions.

Summary

• Pyelonephritis is an infection of the kidney or kidneys.
• This condition results when a bacterial infection in the lower urinary tract spreads to the kidney.
• Lower urinary tract infections are common during pregnancy.
• Pyelonephritis causes chills, a fever, flank pain, and nausea.
• Pyelonephritis is a serious infection that is usually treated in the hospital with IV antibiotics.