Dawkins J C, Fletcher H M, Rattray C A, Reid M, Gordon-Strachan G
Department of Obstetrics and Gynaecology, University of the West Indies, Mona, Kingston 7, Jamaica.
ISRN Obstet Gynecol. 2012;2012:519321. doi: 10.5402/2012/519321. Epub 2012 Nov 14.
Introduction. Pyelonephritis is a common complication of pregnancy. It is also exacerbated by immunocompromised states and also the sickle cell gene. We reviewed this condition in Jamaican women. Method. We did a six year hospital database docket review. We found 102 confirmed cases. Results. Pyelonephritis was found in 0.7% of deliveries. The mean maternal age was 24 ± 5.83 years with 51% primiparity. Most (58.8%) occurred in the second trimester. The main symptoms were loin pain (96.2%) and abdominal pain (84.6%). It was more common on the right side in 67% of cases. On urinalysis, 81.4% had pyuria. The commonest organism was Escherichia coli, in 61% of cases. Patients given Antibiotics prior to admission had quicker resolution, P < 0.02. Haemoglobin S was found in 16% cases (general population 10%; P = 0.002). However diabetes was only found in 1.3% cases (1.5% expected). 61.3% had positive urine culture after treatment showed that 61.3% and 25% had recurrent pyelonephritis. Complications included 32% threatened preterm labour and 17% preterm delivery. About 6% of neonates had intrauterine growth restriction. There were no ICU admissions and no deaths. Conclusion. Early recognition and treatment of pyelonephritis result in good outcome. The condition is more prevalent in patients with the sickle cell gene and recurrence is high.
引言。肾盂肾炎是妊娠期常见的并发症。免疫功能低下状态以及镰状细胞基因也会使其病情加重。我们对牙买加女性的这种病症进行了回顾性研究。方法。我们对六年的医院数据库记录进行了回顾性分析。共发现102例确诊病例。结果。在0.7%的分娩病例中发现了肾盂肾炎。产妇平均年龄为24±5.83岁，初产妇占51%。大多数病例（58.8%）发生在孕中期。主要症状为腰痛（96.2%）和腹痛（84.6%）。67%的病例右侧更为常见。尿液分析显示，81.4%的患者有脓尿。最常见的病原体是大肠杆菌，占61%的病例。入院前接受抗生素治疗的患者病情缓解更快，P<0.02。16%的病例中发现了血红蛋白S（普通人群为10%；P = 0.002）。然而，仅1.3%的病例发现患有糖尿病（预期为1.5%）。治疗后61.3%的患者尿培养呈阳性，其中61.3%和25%的患者有复发性肾盂肾炎。并发症包括32%的先兆早产和17%的早产。约6%的新生儿有宫内生长受限。没有患者入住重症监护病房，也没有死亡病例。结论。早期识别和治疗肾盂肾炎可取得良好疗效。这种病症在镰状细胞基因患者中更为普遍，且复发率较高。
