Pulmonary injury associated with antepartum pyelonephritis

Can patients at risk be identified?

Craig Towers, Carol M. Kaminskas, Thomas J. Garite, Michael P. Nageotte, Wendy Dorchester

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

The development of pulmonary injury in cases of antepartum pyelonephritis is rare but serious. To date, factors that might identify patients at risk have not been determined. We compared 11 patients with pyelonephritis and pulmonary injury with 119 patients with pyelonephritis only. Pulmonary injury was more likely to occur in the more severe cases; however, the presence of a maternal heart rate >110 beats/min and a fever to 103° F 12 to 24 hours before the occurrence of respiratory symptoms in a gestation >20 weeks was highly predictive of pulmonary injury. The most significant predictive factors associated with pulmonary injury were elements of treatment such as fluid overload, use of tocolytic agents, and, to a lesser extent, choice of antibiotic. Therefore, if tocolytic agents are considered at all in the management of acute pyelonephritis in pregnancy, they should be used only in patients with documented cervical change. In addition, urinary output should be monitored very closely. These data also may suggest a cause of the pulmonary edema that is occasionally seen in the management of premature labor with the use of tocolytic agents and fluids in the presence of a possible occult infection.

Original languageEnglish (US)
Pages (from-to)974-980
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume164
Issue number4
DOIs
StatePublished - Jan 1 1991
Externally publishedYes

Fingerprint

Pyelonephritis
Lung Injury
Tocolytic Agents
Pregnancy
Premature Obstetric Labor
Pulmonary Edema
Fever
Heart Rate
Mothers
Anti-Bacterial Agents
Infection

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Pulmonary injury associated with antepartum pyelonephritis : Can patients at risk be identified? / Towers, Craig; Kaminskas, Carol M.; Garite, Thomas J.; Nageotte, Michael P.; Dorchester, Wendy.

In: American Journal of Obstetrics and Gynecology, Vol. 164, No. 4, 01.01.1991, p. 974-980.

Research output: Contribution to journalArticle

Towers, Craig ; Kaminskas, Carol M. ; Garite, Thomas J. ; Nageotte, Michael P. ; Dorchester, Wendy. / Pulmonary injury associated with antepartum pyelonephritis : Can patients at risk be identified?. In: American Journal of Obstetrics and Gynecology. 1991 ; Vol. 164, No. 4. pp. 974-980.
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