Document Detail

Pulmonary injury associated with antepartum pyelonephritis: can patients at risk be identified?
MedLine Citation:
PMID:  2014849     Owner:  NLM     Status:  MEDLINE    
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 greater than 110 beats/min and a fever to 103 degrees F 12 to 24 hours before the occurrence of respiratory symptoms in a gestation greater than 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.
C V Towers; C M Kaminskas; T J Garite; M P Nageotte; W Dorchester
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  164     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-16     Completed Date:  1991-05-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  974-8; discussion 978-80     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of California, Irvine.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Body Fluids / metabolism
Multivariate Analysis
Pregnancy Complications*
Pyelonephritis / complications*,  drug therapy,  metabolism
Respiratory Distress Syndrome, Adult / chemically induced,  etiology*,  therapy
Risk Factors
Tocolytic Agents / adverse effects
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Tocolytic Agents

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