Risk assessment scale for the development of acute pyelonephritis in women at different stages of pregnancy

Konyrov E.M., Shalekenov B.U., Shalekenov S.B., Apenova A.E.

1) Al-Farabi Kazakh National University, Almaty, Kazakhstan; 2) Maternity Hospital No. 5 of Almaty, Kazakhstan

Introduction. The authors consider gestational pyelonephritis as a relevant clinical problem requiring timely diagnosis and a well-grounded choice of treatment strategy.
Aim. To develop and validate a scale for stratifying the risk of acute pyelonephritis in pregnant women, allowing determination of the optimal management strategy (conservative therapy or upper urinary tract drainage) at various gestational stages.
Materials and methods. A retrospective analysis was performed on 161 cases of urinary tract infection in pregnant women: 73 patients observed in 2024 using the proposed scale and 88 patients from 2023, who formed the control group.
Results. Implementation of the scale in 2024 increased the frequency of ureteral stenting (32.8% vs. 17% in 2023) and reduced the number of cases with kidney decapsulation (2.9% vs. 3.5%). A statistically significant increase was observed in the proportion of hospitalizations during the third trimester (20.6% vs. 6.8% in the first trimester), indicating more accurate risk stratification and timely selection of treatment tactics.
Conclusion. The developed scale facilitates objectification of clinical decisions in managing pregnant women with gestational pyelonephritis, ensures timely drainage in high-risk patients, and reduces the frequency of unnecessary invasive interventions.

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About the Authors

Corresponding author: Erkin M. Konyrov – Doctoral Student, Al-Farabi Kazakh National University, Almaty, Kazakhstan; e-mail: doc_konyr@mail.ru

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