[Gestational pyelonephritis: modern aspects of diagnosis and treatment].

Acute gestational pyelonephritis (AGP) is considered to be a complicated urinary tract infection with altered urodynamics on the affected side. We analyzed minimally invasive treatment results achieved in 57 females with AGP. Pyelonephritis has been diagnosed basing on the results of physical examination, urinalysis and urine culturing. Conventional, Doppler ultrasound and MR tomography provided early diagnosis and AGP staging. A timely upper urinary tract drainage with an ureteral stent and adequate antibacterial and antiinflammatory treatment made it possible to avoid open surgical treatment and effectively treat 56 of 57 patients (98.2%). Out of 55 patients with 39-40 week pregnancy, 43 women had normal vaginal delivery and 12 delivered by the cesarian section. In two cases delivery by cesarian section at weeks 36-37 was performed because of individual intolerance of an ureteral stent. All the neonates were born healthy (7-9 points by Apgar score). Recently gained experience in early diagnosis and treatment of AGP and good follow-up results demonstrate a clear benefit from the use of minimally invasive diagnostic and treatment methods.