IMPACT OF ENDOGENOUS INTOXICATION IN DIFFERENT VARIANTS OF UNCOMPLICATED PYELONEPHRITIS IN PREGNANT WOMEN ON THE STATE OF UTERINE-PLACENTAL-FETAL BLOODSTREAM

Objective. To reveal a correlation of changes in uteroplacental blood flow with the degree of endogenous intoxication in pregnant women with uncomplicated pyelonephritis. Subjects and methods. The case histories of pregnancy and childbirth were retrospectively analyzed in 300 patients with uncomplicated pyelonephritis during pregnancy, who were divided into 3 groups: 1) gestational pyelonephritis (n = 100); 2) chronic pyelonephritis with an exacerbation during pregnancy (n = 100); 3) chronic pyelonephritis without exacerbations during pregnancy (n =100). A control group comprised 50 somatically healthy women. Third-trimester Doppler study was conducted to evaluate uterine-placental-fetal bloodstream. The degree of endotoxicosis was determined using the nuclear intoxication index. The variation series procedure in the statistical system SPSS ExactTests was employed to reveal correlations. Results. A correlation was established between the intensity of fetoplacental circulation and the degree of endogenous intoxication in pregnant women with uncomplicated pyelonephritis. The most pronounced changes in uteroplacental blood flow were detected in patients with an active inflammatory process in the kidneys during pregnancy. But even in the absence of acute pyelonephritis during pregnancy, there were significant changes in uteroplacental blood flow. Conclusion. The findings suggest that it is neccesary to elaborate measures for pregravid pregaration in patients with chronic pyelonephritis and for prevention of exacerbations of the inflammatory process during pregnancy.

chronic pyelonephritis, uterine-placental-fetal bloodstream, nuclear intoxication index