OPTIMIZING MANAGEMENT STRATEGIES FOR COMPLICATED GESTATIONAL PYELONEPHRITIS

Abstract

The interaction between pregnancy and gestational pyelonephritis remains an important clinical and public-health concern due to the high frequency of obstetric complications, adverse perinatal outcomes, and severe neonatal morbidity. Chronic pyelonephritis during pregnancy is frequently associated with iron-deficiency anemia (35–70%), pregnancy loss at various gestational stages (15–20%), chronic placental insufficiency (30–35%), and gestosis (35–70%). Additionally, 30–40% of affected pregnancies develop chronic fetal hypoxia, while intrauterine infection occurs in 20–30% of cases, and fetal growth restriction in 12–15%. Chronic renal inflammation markedly reduces maternal adaptive capacity and increases the likelihood of early neonatal mortality.