L16: Renal & Urinary Diseases With Pregnancy Flashcards
Def of Asymptomatic Bacteruria
- Presence of > 100 000 CFU (colony forming unit) / ml urine in
midstream urine sample without symptoms.
Incidence of Asymptomatic Bacteruria
2-7%
Complications of Asymptomatic Bacteruria
Maternal & Fetal
maternal Complications of Asymptomatic Bacteruria
Acute cystitis or pyelonephritis, PIH & abortion or preterm labor.
Fetal Complications of Asymptomatic Bacteruria
IUGR & IUFD
TTT of Asymptomatic Bacteruria
Antibiotics.
- Nitrofurantoin: 100 mg/ 12 hrs for 10 days.
- Others: Ampicillin, amoxicillin or cephalosporins.
Def of Acute Pylonephritis in Pregnancy
Acute infection involving renal pelvis (pyelitis) & interstitial tissue (nephritis).
Predisposing Factors for Acute Pylonephritis in Pregnancy
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Asymptomatic Bacteruria
20-40% of cases develop symptomatic infection if not treated.
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Urinary Stasis
Predisposing Factors for Acute Pylonephritis in Pregnancy
- iatrogenic
Repeated catheterization.
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Diseases
DM, sickle cell disease & immunosuppressive diseases.
Organisms causing Acute Pylonephritis in Pregnancy
Routes of Infection by Acute Pylonephritis in Pregnancy
- Ascending (through lumen).
- Lymphatic.
- Hematogenous
Complications of Acute Pylonephritis in Pregnancy
Maternal & fetal
Maternal Complications of Acute Pylonephritis in Pregnancy
Fetal Complications of Acute Pylonephritis in Pregnancy
IUGR & IUFD
Dx of Acute Pylonephritis in Pregnancy
Dx of Acute Pylonephritis in Pregnancy
- Symptoms
Dx of Acute Pylonephritis in Pregnancy
- Onset of Symptoms
Abrupt
Dx of Acute Pylonephritis in Pregnancy
- Signs
Fever, tachycardia & tenderness in one or both renal angles.
Dx of Acute Pylonephritis in Pregnancy
- INVx
Investigations for Acute Pyelonephritis in Pregnancy
Investigations for Acute Pyelonephritis in Pregnancy
- Urine Analysis
Pus cells > 10/HPF.
Investigations for Acute Pyelonephritis in Pregnancy
- Urine Culture
On both aerobic & anaerobic media.
Investigations for Acute Pyelonephritis in Pregnancy
- Renal US
To detect underlying lesion in resistant cases.
Investigations for Acute Pyelonephritis in Pregnancy
- Single IVP
In resistant cases.
DDx of Acute Pyelonephritis in Pregnancy
From other causes of fever è rigors, vomiting & acute abdomen in pregnancy.
TTT of Acute Pyelonephritis in Pregnancy
TTT of Acute Pyelonephritis in Pregnancy
- General Lines
TTT of Acute Pyelonephritis in Pregnancy
- Antibiotics
- (nitrofurantoin, penicillin or cephalosporins) then → change according to results of culture & sensitivity testing.
TTT of Acute Pyelonephritis in Pregnancy
- TTT of Cause
Relieve obstruction → (ureteric stent or percutaneous nephrostomy).
Degrees of CRF in Pregnancy
Complications of CRF in Pregnancy
Def of AKI in Pregnancy
Condition in which kidneys are temporarily unable to perform their functions.
Etiology of AKI in Pregnancy
CP of AKI in Pregnancy
Prevention of AKI in Pregnancy
TTT of AKI in Pregnancy
Risks of Pregnancy after Renal Transplant
Managment of Pregnancy after Renal Transplant
Managment of Pregnancy after Renal Transplant
- Preconceptional Care
Managment of Pregnancy after Renal Transplant
- Managment During Pregnancy
- Close observation & monitoring of renal function.
- Treatment of bacteriuria.
- Follow up of immunosuppressive therapy.