A clinical study has been made on 76 cases of acute pyelonephritis out of 28,104 patients who were delivered at Ilsin Christian Hospital from January 1986 to December 1989. And 87 normal cases during the same period were selected as a control group.
The incidence of with acute pyelonephritis during pregnancy was 107 cases (0.3%). The acute pyelonephritis developed in 47.7% in second trimester and in 42.1% in third trimester.
Common symptoms and physical findings were flank pain(71.1%), fever(75.1%) and tenderness on costovertebral angle(87.8%).
Urine cultures were positive in 81.4% of cases, the most frequent organism was Esherichia coli (67.1%) which was sensitive to the cefoperazone. The next frequent organism was coagulase negative staphyloccocci.
Average gestational age was 39.3 weeks and average birth weight was 3.20kg.
Intrapartum and postpartum maternal morbidity was significantly higher in the study group than in the control group (P<0.01).
Fetal morbidity was 63.1% in the study group and 32.2% in the control group, which was statistically significant (P<0.01).
As far as fetal morbidity was concerned, only fetal distress showed significant (P<0.05).
Patients who had fever for more than 3 days showed higher incidence of fetal and/or maternal morbidity (P<0.01).
There were five cases (6.6%) of recurrence and readmission.
In conclusion it would seem that acute pyelonephritis during pregnancy is not a causative facter in prematurity or low birth weight but it is important that it be treated quickly during pregnancy because of the higher incidence of fetal and/or maternal morbidity.