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Journal of the Korean Academy of Family Medicine 1991;12(3):23-29.
Published online March 1, 1991.
Clinical study on acute pyelonephritis in pregnancy.
Hae Seon Oughn, Hye Jeong Kim, Jong Seung Jeong, Sang Young Lee, Yu Duk Choi
임신중 급성 신우신염에 관한 임상적 연구
이상영, 온해선, 최유덕, 정종승, 김혜정
중앙길병원 가정의학과 동인천길병원 산부인과
Acute pyelonephritis is one of the most common medical complications in pregnancy and is encountered in as many as 1-2% of all gestations.
This study was performed to evaluate the clinical importance of acute pyelonephritis during pregnancy such as incidence, chinical symptoms and signs, urine culture and sensitivities, treatment, and recurrence. Ninety five cases of acute pyelonephritis admitted to the obstetric department of DongIncheon Gil's Hospital during 5 years from January 1984 to December 1988 were selected for this study.

The results of this study were as follows;
1. The incidence of acute pyelonephritis during pregnancy was 1.31%, Analysis of cases by trimester showed higher prevalence in the third trimester.(47.4%)
2. The most common symptom was lower urinary tract symptom (71.6%), and the next were chills (60%), backache(45.2%), nausea & vomiting(10.5%) in order, all cases with few execeptions had fever and in 54.7%, it was 38.3C˚ or more. 88.4% of cases women had tenderness at the costovertebral angle and this tenderness was predominant in the right side in 54.7%.
3. In 81.0% of cases, bacteria were isolated from the urine. The most common microorganism isolated was E. coli(68.8%) and the next was Enterobacter(7.4%). E. coli was highly sensitive to Amikacin(84.9%), Cefazolin(79.2%), Gentamicin(62.3%) and Ampicillin(58.5%).
4. We treated most of the cases of antepartum acute pyelonephritis with ampicillin and these cases discharged from the hospital after average 5. 7 days duration. The other cases were treated solely with Cefazolin or Ampicillin plus Gentamicin, or Ampicllin plus Kanamycin.
5. 72.6% of the patients were completely afebrile in 2 days after the onset of therapy, 24.2% were afebrile within 3 days or 4 days.
6. 23 cases(24.2%) developed recurrent acute pyelonephritis.


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