Hafez Wael, Al Shareef Jalal, Alyoussef Afraa, Ghanem Mirvat, Abazid Reem Rizk, Yadav Antesh, Rashid Asrar, Sayfoo Fardeen Mohammad, Venkataramani Sneha, Restrepo Pamela Orozco, Elkott Mohamed Maher, Lakshman Vikram Satish, Arief Taahira, Mohammed Alaa Gamal, Abdulaal Fatema, Hossam Yossef
Department of Internal Medicine, Medical Research and Clinical Studies Institute, The National Research Centre, Dokki, Cairo Governorate, Egypt.
Department of Gynecology, NMC Royal Hospital, Abu Dhabi, United Arab Emirates.
Int J MCH AIDS. 2024 May 31;13:e012. doi: 10.25259/IJMA_15_2024. eCollection 2024.
Pulmonary injuries resulting from urinary tract infections (UTIs) during pregnancy are rare. Prompt detection of pulmonary complications in pregnant patients with UTIs is crucial to prevent adverse outcomes in both the mother and the fetus. These complications may include respiratory issues, pulmonary edema, and exacerbation of preexisting conditions, such as asthma. We aimed to detect reported cases of pulmonary injury after UTIs among pregnancies.
We retrospectively reviewed the reported cases and articles in the PubMed database up to September 2023 on pulmonary injury after UTIs among pregnancies through a detailed search strategy. The titles and abstracts of the selected 15 articles were assessed, and ultimately, 7 articles were chosen based on adherence to our inclusion and exclusion criteria.
Approximately 1-2% of women may develop acute pyelonephritis due to persistent UTIs, which has been associated with an increased risk of pulmonary edema in certain cases. UTIs can affect pulmonary health. Uremia, a consequence of UTIs, can lead to alterations in the respiratory drive, mechanics, muscle function, and gas exchange. Furthermore, urinary infection-induced inflammation activates neutrophils and promotes their recruitment to the lungs, compromising lung function and damaging the surrounding tissue.
Although systematic research on this topic is limited, there may be a link between UTIs and pulmonary damage. However, it remains unclear whether pregnancy exacerbates this association. For maternal health, child health, and the whole public health, it is important to raise awareness of physicians and gynecologists, as well as the different specialties like emergency and intensive care units, with more information about pulmonary injury after UTI in pregnancy; it is important to note that UTIs may not directly cause pulmonary complications, but physiological changes associated with pregnancy can increase this risk, so more care, observation, early detection, and treatment are critical for treating these complications and achieving best outcome in pregnant women with UTIs. More research is needed in this area, as the mechanism underlying the existence of pulmonary damage post-UTI in pregnancy is unclear.
孕期因尿路感染（UTIs）导致的肺部损伤较为罕见。及时发现孕期尿路感染患者的肺部并发症对于预防母婴不良结局至关重要。这些并发症可能包括呼吸问题、肺水肿以及哮喘等原有疾病的加重。我们旨在检测孕期尿路感染后肺部损伤的报告病例。
我们通过详细的检索策略，对截至2023年9月PubMed数据库中关于孕期尿路感染后肺部损伤的报告病例和文章进行了回顾性分析。对所选15篇文章的标题和摘要进行了评估，最终根据是否符合我们的纳入和排除标准选择了7篇文章。
约1%-2%的女性可能因持续性尿路感染而发生急性肾盂肾炎，在某些情况下，这与肺水肿风险增加有关。尿路感染会影响肺部健康。尿毒症作为尿路感染的后果，可导致呼吸驱动、力学、肌肉功能和气体交换的改变。此外，尿路感染引起的炎症会激活中性粒细胞并促使其募集到肺部，损害肺功能并损伤周围组织。
尽管关于该主题的系统性研究有限，但尿路感染与肺部损伤之间可能存在联系。然而，尚不清楚妊娠是否会加剧这种关联。对于孕产妇健康、儿童健康和整个公共卫生而言，提高医生、妇科医生以及急诊科和重症监护病房等不同专科对孕期尿路感染后肺部损伤的认识非常重要；需要注意的是，尿路感染可能不会直接导致肺部并发症，但与妊娠相关的生理变化会增加这种风险，因此更多的护理、观察、早期发现和治疗对于治疗这些并发症以及使孕期尿路感染患者获得最佳结局至关重要。由于孕期尿路感染后肺部损伤存在的潜在机制尚不清楚，该领域需要更多的研究。
