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mnumsb-180908134115 (1).pdf

  1. 1. MNUMS623 Ambaselmaa.B
  2. 2.  Pyelonephritis is inflammation of the kidney parenchyma, pelvis, calyx and hilum, typically due to a unspecified bacterial infection
  3. 3.  1-3 percent of pregnant woman have pyelonephritis  20.7 percent of pyelonephritis patients are pregnant http://mongolmed.mn/article/3088
  4. 4.  Bacteriuria was detected in 42 (70%) patients. However,  18 (30%) patients had negative results for urine culture.  E. coli was the dominant pathogen in 33 (78.6%)  Klebsiella in 8 (19%)  staphylococcus in 1 (2.4%) (PDF) Acute Pyelonephritis in Pregnancy and the Outcomes in Pregnant Patients. Available from: https://www.researchgate.net/publication/282392722_Acute_Pyelonep hritis_in_Pregnancy_and_the_Outcomes_in_Pregnant_Patients [accessed Sep 05 2018]. Arch Clin Infect Dis. 2015;10(3):e28886
  5. 5. (PDF) Acute Pyelonephritis in Pregnancy and the Outcomes in Pregnant Patients. Available from: https://www.researchgate.net/publication/282392722_Acute_Pyelonephritis_in_Pregnancy_ and_the_Outcomes_in_Pregnant_Patients [accessed Sep 05 2018].
  6. 6.  Mechanic/ urinary tract(urether,pelvis) widen, urine stasis/  Hormonal change/nephron metabolitic disorders occur/
  7. 7.  №1 Anamnesis/ remember if patient had a drug it can be asymptomatic/  №2 Symptoms ◦ a fever greater than 38.9°C ◦ pain in the abdomen, back, side, or groin ◦ painful or burning urination ◦ cloudy urine ◦ pus or blood in the urine ◦ urgent or frequent urination ◦ fishy-smelling urine
  8. 8.  №3 examination /no kidney palpation/  №4 Labarotory tests  №5 Imaging tests such as ultrasound and also can be CT /not in pregnant women/  №6 Radioactive imaging/DMSA scan/ not in pregnant women
  9. 9.  A DMSA scan is a radionuclide scan that uses dimercaptosuccinic acid (DMSA) in assessing renal morphology, structure and function. Radioactive technetium-99m is combined with DMSA and injected into a patient, followed by imaging with a gamma camera. A DMSA scan is usually static, other radiotracers are usually used with dynamic imaging to assess renal function.
  10. 10.  If you can treat acute pyelonephritis there is no problem in woman and fetus
  11. 11.  It can be dangerous ◦ Hypertension ◦ Preeclamsia ◦ Miscarriage ◦ Stillbirth
  12. 12.  Check urinary tract blockage  Antibiotic  Pain management  Fluid 1.5-2l in a day
  13. 13.  Penicillins, including amoxicillin, ampicillin  Cephalosporins, including cefaclor, cephalexin  Erythromycin  Clindamycin mayoclinic.org/healthy-lifestyle/pregnancy-week- by-week/expert-answers/antibiotics-and- pregnancy/faq-20058542
  14. 14.  tetracycline (Achromycin)  doxycycline hydrochloride (Vibramycin)  metronidazole (Flagyl)  Streptomycin sulfate  Chloramphenicol  Levomycetinum natrium succinate
  15. 15.  http://www.seq.es/seq/0214-3429/26/1/artero.pdf
  16. 16.  Apply heat. Place a heating pad on your abdomen, back or side to ease pain.  Use pain medicine. For fever or discomfort, take a nonaspirin pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Motrin IB, Advil, others).  Stay hydrated. Drinking fluids will help flush bacteria from your urinary tract. Avoid coffee and alcohol until your infection has cleared. These products can worsen the feeling of needing to urinate. https://www.mayoclinic.org/diseases- conditions/kidney-infection/diagnosis- treatment/drc-20353393
  17. 17.  Kidney scarring. This can lead to chronic kidney disease, high blood pressure and kidney failure.  Blood poisoning (septicemia). Your kidneys filter waste from your blood and return your filtered blood to the rest of your body. Having a kidney infection can cause the bacteria to spread through your bloodstream.  Pregnancy complications. Women who develop a kidney infection during pregnancy may have an increased risk of delivering low birth weight babies. https://www.mayoclinic.org/diseases- conditions/kidney-infection/diagnosis- treatment/drc-20353393
  18. 18.  +Kidney and fat’s abscess  +Kidney tissue necrosis  +Kidney failure  +chronic pyelonephritis
  19. 19. Thank you for yor attenion

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