Pyelonephritis In Pregnant Women Research Articles

Clinical and anthropometric parallels in the diagnostics of pyelonephritis in pregnant women

BACKGROUND: The most dangerous disease in the structure of urinary tract infections during pregnancy is pyelonephritis. Favorable ground for its occurrence is created by anatomical and physiological changes in the urinary system in pregnant women against the background of gestational restructuring of the body. It seems very relevant to study the constitutional features of pregnant women with pyelonephritis and reference points - markers associated with the risk of developing pyelonephritis, the individual characteristics of its course and the effectiveness of therapy using the fundamental basis of clinical anthropology.
 AIM: Evaluation and comparative analysis of anthropometric and bioelectrical impedance body parameters in pregnant women with pyelonephritis.
 MATERIALS AND METHODS: The study included 94 pregnant women with pyelonephritis hospitalized in the urological department of the Clinical Regional Hospital (Krasnoyarsk) from 2019 to 2021. In addition to traditional tests, anthropometric and bioelectrical impedance analysis was carried out to assess the constitutional features and criteria of normal and pathological variability boundaries of pregnant women with pyelonephritis. The control group included 39 women with physiological course of pregnancy without urological diseases.
 RESULTS: The constitutional identification in the group of women with pyelonephritis in pregnancy was dominated by the mesomorph body type, with a smaller proportion presenting the endomorph type and the rarely detected central and ectomorph types. Vector analysis of soma components in pregnant women with pyelonephritis are characterized by high mesomorph scores reflecting the degree of skeletal and muscular development compared to the control group, with the lowest ectomorph values. According to bioelectrical impedance analysis, most patients have significant differences in a number of body composition parameters. Morphometric features of the pelvicalyceal system on the affected side are most prominent in the representatives of endomorph and central body types. There are significant correlations between the degree of pelvicalyceal system dilatation on the affected side and anthropometric and bioimpedance parameters of body composition.
 CONCLUSION: The study revealed a number of clinical and anthropometric parallels and constitutional features of pregnant women with pyelonephritis with the characteristics of the component body composition. Relationships have been established between various indicators, which at first glance are not related to each other, but have a significant impact on the clinical manifestations of gestational pyelonephritis. The results of the pilot study and further development of the methodology will make it possible to determine the most significant constitutional predictors of the development of pyelonephritis in pregnancy and the possibility of conducting preventive therapy.

Biotechnical System of Differential Diagnostics of Serous and Purulent Pyelonephritis in Pregnant Women Based on Fuzzy Logic for Decision-Making.

Urologists and nephrologists attribute pyelonephritis of pregnant women to the category of complicated upper urinary tract infections that threaten the development of a severe purulent-septic process. The frequency of pyelonephritis in pregnant women ranges from 12.2 to 33.8%. In this research, laboratory indicators of the state of immunity and lipid peroxidation using fuzzy decision logic are used to improve the quality of differential diagnosis of serous and purulent pyelonephritis in pregnant women. A space of informative indicators was formed that characterize the state of immune changes, making it possible to carry out the differential diagnosis of pyelonephritis forms in pregnant women with high accuracy. Results of the operation of the obtained decision rules in the control sample showed that the diagnostic efficiency of the proposed method reaches 93%, which is acceptable for use in medical practice.

Estrogen receptors in human bladder cells regulate innate cytokine responses to differentially modulate uropathogenic E. coli colonization

The bladder epithelial cells elicit robust innate immune responses against urinary tract infections (UTIs) for preventing the bacterial colonization. Physiological fluctuations in circulating estrogen levels in women increase the susceptibility to UTI pathogenesis, often resulting in adverse health outcomes. Dr adhesin bearing Escherichia coli (Dr E. coli) cause recurrent UTIs in menopausal women and acute pyelonephritis in pregnant women. Dr E. coli bind to epithelial cells via host innate immune receptor CD55, under hormonal influence. The role of estrogens or estrogen receptors (ERs) in regulating the innate immune responses in the bladder are poorly understood. In the current study, we investigated the role of ERα, ERβ and GPR30 in modulating the innate immune responses against Dr E. coli induced UTI using human bladder epithelial carcinoma 5637 cells (HBEC). Both ERα and ERβ agonist treatment in bladder cells induced a protection against Dr E. coli invasion via upregulation of TNFα and downregulation of CD55 and IL10, and these effects were reversed by action of ERα and ERβ antagoinsts. In contrast, the agonist-mediated activation of GPR30 led to an increased bacterial colonization due to suppression of innate immune factors in the bladder cells, and these effects were reversed by the antagonist-mediated suppression of GPR30. Further, siRNA-mediated ERα knockdown in the bladder cells reversed the protection against bacterial invasion observed in the ERα positive bladder cells, by modulating the gene expression of TNFα, CD55 and IL10, thus confirming the protective role of ERα. We demonstrate for the first time a protective role of nuclear ERs, ERα and ERβ but not of membrane ER, GPR30 against Dr E. coli invasion in HBEC 5637 cells. These findings have many clinical implications and suggest that ERs may serve as potential drug targets towards developing novel therapeutics for regulating local innate immunity and treating UTIs.

Antimicrobial susceptibility patterns of uropathogens isolated from pregnant women in KwaZulu-Natal Province: 2011 - 2016.

Urinary tract infection (UTI) is one of the most common infections during pregnancy, which can lead to significant maternal and perinatal morbidity and mortality if left untreated. Challenges when treating UTIs in pregnancy include fetal protection and resistance development of uropathogens. Currently, the Essential Medicines List recommends nitrofurantoin to treat cystitis and ceftriaxone to treat pyelonephritis in pregnant women. To determine common pathogens causing UTI in pregnancy and their antibiotic susceptibility patterns. A retrospective analysis was performed of laboratory data for positive urine specimens from obstetric departments of 6 KwaZulu- Natal Province hospitals during 2011 - 2016. Identification and susceptibility testing were performed using the VITEK 2 system. Results were interpreted according to the breakpoints of the Clinical and Laboratory Standards Institute, USA. From 5 971 positive urine specimens, the most common isolate was Escherichia coli (n=3 236; 54.2%), followed by Klebsiella pneumoniae (n=770; 12.9%). Group B streptococcus (GBS) (n=239; 4.0%) and Enterococcus faecalis (n=251; 4.2%) were the most common Gram-positive pathogens. E. coli displayed significant resistance to trimethoprim-sulfamethoxazole (65.1%), cephalothin (38.3%), cefuroxime (27.3%), ciprofloxacin (16.9%) and amoxicillin-clavulanic acid (17.1%). Resistance to ceftriaxone and nitrofurantoin remained low ‒ 9.1% and 7.7%, respectively. Among Gram-positive pathogens, GBS displayed 100% penicillin susceptibility and E. faecalis showed 92.9% susceptibility to ampicillin. E. coli is unsurprisingly the most common cause of UTI in pregnancy in KwaZulu-Natal. Susceptibility to ceftriaxone and nitrofurantoin remains good. Among Gram positives, GBS is prevalent and susceptible to penicillin, while E. faecalis is susceptible to ampicillin. As antimicrobial resistance evolves, routine surveillance is necessary to modify recommended empirical antibiotic use.

Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

Epidemiological and clinical aspects of chronic pyelonephritis in pregnant women and osteopathic follow-up of pregnant women with chronic pyelonephritis

The article considers current issues of epidemiology, etiology and pathogenesis of chronic pyelonephritis in pregnant women at the present stage, and demonstrates its effect on the gestational process and perinatal outcomes. The article presents classification of chronic pyelonephritis in pregnant women, the main clinical manifestations, as well as the possibilities for diagnosis of the disease. Both medical and non-medical treatment methods are considered. Particular attention is paid to osteopathic diagnosis and correction of somatic dysfunctions in pregnant women in order to prevent exacerbations of chronic pyelonephritis and reduce the risk of obstetric complications.

Acute Pyelonephritis in Pregnant Women: Features of Treatment

Introduction. The prevalence of acute pyelonephritis (AP) in pregnant women varies from 3% to 18%. There is an increase in the AP incidence in pregnant women over the past two decades with the growth of purulent-destructive forms incidence. Currently, there is no unity of views on the issues of therapeutic tactics in pregnant women according to the literature data. Besides, there are no clear criteria for the timing and choice of the method of upper urinary tract (UUT) drainage. This circumstance determines the relevance of the study of the effectiveness of minimally invasive methods of AP treatment and UUT obstructive lesions in pregnant women.Purpose of the study. To study the effectiveness of minimally invasive methods of AP treatment in pregnant women.Materials and methods. The results of AP treatment and various UUT obstructive lesions in 293 pregnant women from 2013 to 2018 years were analyzed. Patients` age: from 15 to 42 years (mean is 25 years). At the same time, 237 (81%) patients were in the second and third trimesters of pregnancy. Urodynamic disorders were resolved in 123 (42%) patients with stenting, ureter catheterization, and percutaneous nephrostomy (PNS). In 28 (9.5%) cases, UUT obstruction was caused by kidney stones, in 7 (2.4%) cases contact ureterolithotripsy (CULT) was performed on this occasion.Results. In 16 (5.4%) patients developed complications, such as sepsis and septic shock. Purulent-destructive AP forms were observed in 8 (2.7%) pregnant women. AP was stopped in all patients against the background of the restored urine passage and ongoing conservative therapy. The need for lumbotomy, kidney`s decapsulation, carbuncles` excision, nephrectomy did not arise in any case. Eventually, 221 (75%) pregnant women had timely deliveries. Preterm birth was observed in 52 (17%) pregnant women. Maternal mortality has not been reported. Antenatal fetal death was detected in 2 (0.6%) cases within 1-2 months after discharge from the urological division.Conclusion. Timely conservative managment of AP in pregnant women with adequately restored of urine passage allows to minimize severe septic complications and avoid traumatic open surgical interventions.The study did not have sponsorship. The authors have declared no conflicts of interest.

Urinary Tract Drainage Selection in Case of Pyelonephritis in Pregnant Women

The article presents an analysis of the treatment results of 1122 patients with pyelonephritis in pregnancy at different gestational periods (from 6 to 39-40 weeks of pregnancy). The age of the patients was from 16 to 41 years, the average age was 26.15 ± 7 years. The indications and methods of urinary tract drainage in pregnant women were analyzed depending on the causes of urodynamic disturbances (kidney stone disease, decreased urinary tract tone, ureters compression by the uterus, vesico-urethral reflux) pregnancy term; pyelonephritis in pregnancy stage (serous/ purulent). Errors in the patients’ management after purulent pyelonephritis in pregnancy are considered. The expediency of examining and treating patients with risk factors for urinary tract infections during pregnancy were indicated at the stage of preparing a woman for pregnancy. Antegrade draining of the urinary tract is indicated for pregnant women from the 31st pregnancy week (and even shorter periods with a pronounced violation of urodynamics) with the presence of knee-shaped deviation in the ureter`s upper third and with suspected purulent process. Therefore, nephrostomy draining provides a more adequate outflow of urine from the affected kidney and makes it possible to control daily diuresis. It is necessary to conduct active monitoring of pregnant women with the presence of internal ureteral stents and their timely replacement. It is advisable to remove the drainage 3-4 weeks after birth, depending on the causes of the urodynamics` disorders. Symptom build-up dynamics, severity of intoxication, multi-organ lesion, the possibility of antenatal death of the fetus require urgent choice of the method of urinary tract drainage and the early initiation of intensive therapy in patients with suspected purulent process. Antimicrobial therapy should be carried out in accordance with the Russian guidelines on Urinary tract infections.TThe study did not have sponsorship. The authors have declared no conflicts of interest.

A Decision Support System for the Differential Diagnosis of Pyelonephritis in Pregnant Women Based on Immune and Oxidative Status

Application of modern mathematical methods and information technologies for accurate differential diagnosis of various forms of pyelonephritis in pregnant women is described. The differential diagnosis is based on indicators of the immune and oxidative status. The decision rules suggested in this work were verified on a control sample. The verification showed that the diagnostic efficiency of the proposed method reaches 93%, which is acceptable for use in medical practice.

Pyelonephritis in pregnant women: where to start?

Pyelonephritis in pregnant women is an urgent problem for urology. In the Russian clinical guidelines, there are disagreements on the classification of pyelonephritis. This is probably the cause of its overdiagnosis in pregnant women, as evidenced by the increase in the statistical frequency of pregnant pyelonephritis. This situation is the reason for the unjustified etiotropic therapy of pyelonephritis in this category of patients. On the other hand, the diagnosis of chronic pyelonephritis can cause an underestimation of the severity of the patient’s condition and increase the risk of an adverse outcome of the disease. Along with this, the literature has accumulated data on the absence of a morphological substrate of inflammation during periods of so-called remission, and that pyelonephritis should be considered as reinfection. All this call into question the eligibility of the term chronic in relation to pyelonephritis. In the available literature there are few data on the physiology of the urinary tract in pregnant women. Nevertheless, the accumulated experience indicates the safety of excretory function despite dilatation of the upper urinary tract. In addition, there are no studies indicating the benefits of drainage of both asymptomatic and symptomatic hydronephrosis in pregnancy. All this does not allow associating pregnant pyelonephritis with obstructive in non-pregnant patients, and asymptomatic dilatation of the upper urinary tract should be interpreted as a physiological state.

Pyelonephritis in Pregnancy: modern draining tactics

Many publications in foreign and domestic papers are devoted to pyelonephritis in pregnancy. At the same time, aspects of the upper urinary tract (UUT) drainage, indications / lack of indications, and the duration of UUT drainage during kidney infections in pregnant women are bypassed. Etiological treatment of this pathology is well described in the European Association of Urology guidelines and American Urological Associations guidelines in accordance with the recommendations of the Food and Drug Administration (FDA). However, there are no references to the management of patients with UUT dilatation, associated with pyelonephritis in pregnant women. The Russian Clinical Guidelines for Urology (2018) also contains very brief information on this issue. Thus, each urological clinic of the Russian Federation has formed its own views on the draining tactics for pyelonephritis in pregnant women, which our colleagues have been following for years and decades. This publication presents an analysis of the literature sources focusing on the current state of the problem of pyelonephritis in pregnancy and the «neсessity» of the UUP drainage. It is intended to initiate a review of the established «tradition» and avoid a significant number of catheter and stent-related complications.

The Use of Mobile Educational Tools to Improve Antimicrobial Prescription for the Treatment of Acute Pyelonephritis in Pregnancy: A Retrospective Cross-sectional Study.

To analyze the prescription of antimicrobial agents for pregnant women admitted into the obstetrics service who presented with acute pyelonephritis. Three cross-sectional studies were performed comparing the prescription of antimicrobials for pyelonephritis in pregnant women in the time periods evaluated (2010-2011: 99 patients evaluated; 2013: 116 patients evaluated; 2015: 107 patients evaluated), at the Hospital Fêmina, Porto Alegre, in the state of Rio Grande do Sul, Brazil. The analysis was performed before and after the promotion of an institutional protocol for the treatment of pyelonephritis during pregnancy, and on a third occasion after the introduction of a smartphone-based mobile educational tool. The evaluation of the prescribing physicians and the adequacy of the prescriptions between the different periods studied revealed a significant increase in appropriate conduct for the choice of antimicrobial (2010: 83.8%; 2013: 95.7%; and 2015: 100%), route of administration (2010: 97%; 2013: 100%; and 2015: 100%), and interval (2010: 91.9%; 2013: 95.7%; and 2015: 100%), following the introduction of the protocol, and again after the implementation of the software application with orientations on the antimicrobial treatment. The use of specific mobile applications should be encouraged to attain a better quality and accuracy in prescriptions and to include strategies that not only reduce the risk of negative outcomes, but also improve the quality of care and treatment for maintaining the health both of the mother and of the baby.

Phytotherapy for the prevention of exacerbation of chronic pyelonephritis in pregnant women

Phytotherapy for the prevention of exacerbation of chronic pyelonephritis in pregnant women

THE CURRENT STATE OF ANTIBIOTIC RESISTANCE AND THE COMPOSITION OF PATHOGENS OF URINARY TRACT INFECTIONS IN PREGNANT WOMEN

Introduction.The main treatment component of asymptomatic bacteriuria, acute cystitis and pyelonephritis in pregnant women is antibiotic therapy, which in many patients is prescribed empirically. For successful selection of the drug, it is necessary to know both the structure of pathogens and the current profile of their antibiotic resistance.Purpose of research.The study of species composition and resistance to antibiotics of bacteria that cause urinary tract infections (UTIs) in pregnant women in the Moscow RegionMaterials and methods.The study included 104 pregnant women with uncomplicated UTIs who were observed and treated at the Lapino Clinical Hospital between 2016 and 2017. The material for bacteriological studies was the midstream portion of urine or urine collected by a catheter.Results.90 patients had asymptomatic bacteriuria, 10 had acute cystitis, and 4 had acute gestational pyelonephritis. The structure of the pathogens of UTI is presented: E. coli, Enterococcus faecalis, Klebsiella pneumoniae, Proteus spp., Staphylococcus spp., Streptococcus spp., Enterobacter cloacae. The most frequently detected pathogens were E. coli (67.3%) and E. faecalis (50%). Resistance rate of E.coli strains more than 20% was detected to ampicillin (36.4%), amoxicillin / clavulanate (23.2%), trimethoprim / sulfamethoxazole (27.4%), nalidixic acid (20.7%), cephalosporins 2 and 3 generation (respectively, 25.7% and 24.3%). Resistance rate more than 20% in Enterobacteriaceae family strains was detected to trimethoprim/sulfamethoxazole (24.4%), nalidixic acid (20.7%), cephalosporins 2 generations (21.7%). Antibiotic resistance of E.coli and other Enterobacteriaceae family taxons less than 10% was noted only with respect to carbapenems (0%) and fosfomycin (1.5% and 3.5%, respectively).Conclusions.It is expedient to use the obtained data on the composition and sensitivity profile of uropathogens in UTIs in pregnant women when choosing starting empirical antibiotic therapy. Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest.

Прогнозирование течения различных форм пиелонефрита у беременных по изменениям в параметрах врожденного иммунитета

Прогнозирование течения различных форм пиелонефрита у беременных по изменениям в параметрах врожденного иммунитета

White Blood Cell Cast in Urine in Acute Pyelonephritis in Pregnant Women

White Blood Cell Cast in Urine in Acute Pyelonephritis in Pregnant Women

Влияние эндогенной интоксикации при различных вариантах неосложненного пиелонефрита беременных на состояние маточно-плацентарно-плодового кровотока

Влияние эндогенной интоксикации при различных вариантах неосложненного пиелонефрита беременных на состояние маточно-плацентарно-плодового кровотока

The possibilities of serum cystamine C in diagnostic of pyelonephritis in pregnant women Hematology.

The cystamine C is considered as one of markers of functional condition of pregnant women. The actual study was carried out to assess possibility of applying cystamine C as a biological marker of pyelonephritis in pregnant women. The sampling consisted of 126 pregnant women with various terms of gestation. The participants were separated in two groups. The group I included 64 women with pyelonephritis and the group II included 62 women without pyelonephritis. Te serum values of cystamine C were detected using enzyme-linked immunosorbent assay. The statistical analysis was implemented using non-parametric methods, including Kruskal-Wallis criterion for comparison of 3 independent groups and Mann-Whitney (Wilcoxon) criterion for a posteriori comparisons. The comparative analysis of values of cystamine C in pregnant women discovered, depending on term, increasing of its level since term II - 0.815 (0.622; 0.914) and even higher values in term III - 1.076 (0.917; 1.463) (p=0.0007). This trend repeats at minute analysis of indices of cystamine C in each group separately. The differences in values of cystamine C in two groups in total and between terms were lower statistically significant levels. However, in the group of women with pyelonephritis its values in terms I and III were higher than in the group of women without pyelonephritis. The highest values of content of cystamine C in pregnant women (p=0.0007) were observed in term III. The inter-group differences of serum values of content of cystamine C were absent that does not allow to recommend it as a early marker of damage of kidneys in pregnant women with pyelonephritis.

Routine blood cultures in the management of pyelonephritis in pregnancy for improving outcomes.

Pyelonephritis is a type of urinary tract infection (UTI) that affects the upper urinary tract and kidneys, and is one of the most common conditions for hospitalisation among pregnant women, aside from delivery. Samples of urine and blood are obtained and used for cultures as part of the diagnosis and management of the condition. Acute pyelonephritis requires hospitalisation with intravenous administration of antimicrobial agents. Several studies have questioned the necessity of obtaining blood cultures in addition to urine cultures, citing cost and questioning whether blood testing is superfluous. Pregnant women with bacteraemia require a change in the initial empirical treatment based on the blood culture. However, these cases are not common, and represent approximately 15% to 20% of cases. It is unclear whether blood cultures are essential for the effective management of the condition. To assess the effectiveness of routine blood cultures to improve health outcomes in the management of pyelonephritis in pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register without language or date restrictions (31 December 2014). Randomised controlled trials and quasi-randomised trials comparing outcomes among pregnant women with pyelonephritis who received initial management with or without blood cultures. Cluster-randomised trials were eligible for inclusion in this review but none were identified. Clinical trials using a cross-over design were not eligible for inclusion. Two review authors independently assessed one trial report for inclusion. We identified one trial report but this was excluded. No clinical trials met the inclusion criteria for this review. There are no large-scale randomised controlled trials to assess outcomes in the management of pyelonephritis in pregnancy with or without blood cultures. Randomised controlled trials are needed to evaluate the effectiveness of managing pyelonephritis in pregnant women with or without blood cultures, and to assess any adverse outcomes as well as the cost-effectiveness of excluding blood cultures from treatment.

Factores de riesgo asociados al desarrollo de pielonefritis aguda entre las gestantes afiliadas a una Empresa Administradora de Planes de Beneficio en cuatro ciudades de Colombia. Estudio de casos y controles

<p><strong>Objetivo:</strong> identificar factores de riesgo relacionados con pielonefritis aguda durante la gestación en las gestantes de Barranquilla, Bogotá, Bucaramanga, Cali y Medellín (Colombia), afiliadas a una empresa administradora de planes de beneficio.</p><p><strong>Materiales y métodos:</strong> estudio de casos y controles, con dos controles por caso. Criterios de selección: gestantes que presentaron parto entre el 1 de enero de 2008 y 31 de diciembre de 2012, en las diferentes instituciones prestadoras de servicios de salud de una empresa administradora de planes de beneficio en Colombia; se excluyeron aquellas con anomalías del tracto urinario. Se definieron como caso aquellas que tenían diagnóstico de pielonefritis aguda durante el embarazo, y como control las gestantes con parto atendido en el mismo periodo, sin diagnóstico de pielonefritis. Los casos fueron seleccionados por conveniencia de manera consecutiva, los controles de manera aleatoria. Se midieron las variables gestacionales, sociodemográficas y las comorbilidades. Se evaluó la asociación con análisis bivariado y multivariado.</p><p><strong>Resultados:</strong> se halló una incidencia de 18 casos de pielonefritis por 10.000 gestantes. El diagnóstico se realizó entre la semana 5 y 38 de gestación, la mayoría durante el segundo (40,2 %) y tercer (48,0 %) trimestre. Ningún caso presentó antecedentes de pielonefritis. Se halló asociación entre pielonefritis aguda y primigestante (OR = 1,94; IC 95 %: 1,13- 3,33), adolescente (OR = 2,85 ; IC 95 %: 1,51-5,40) e infección del tracto urinario previa al embarazo (OR = 2,29; IC 95 %: 1,17-4,44).</p><p><strong>Conclusión:</strong> ser primigestante, adolescente y con antecedente de infección baja del tracto urinario previa al embarazo son factores de riesgo para pielonefritis aguda gestacional.</p>