CLINICAL SIGNIFICANCE OF PYELECTASIS IN PREGNANT WOMEN WITH A SYMPTOMATIC BACTERIURIA

Abstract

Abstract

Background: Renal pelvi-calyceal dilatation is the result of urine retention in the upper urinary tract, it is referred also to as pyelectasis. Dilatation of pelvicalyceal system may help in differentiating between significant and non-significant bacteriuria. As Signiant asymptomatic bacteriuria can progress to symptomatic urinary tract infection in pregnant ladies so can help in prevention. Aim of the study: To investigate the correlation between grades of pyelectasis and the significant increasing risk of occurrence of significant asymptomatic bacteriuria in pregnant women. Study design & setting: A case control study conducted at Al-Yarmouk Teaching Hospital, Obstetrics and Gynecological Department and extended through period from March 2020 to December 2020.Materials & methods: This study included ninety pregnant women with single viable fetus with gestational age ranged between (16th to 20th week +6days) according to their accurate LMP (last menstrual period) and early ultrasound scan, with ultrasound evidence of right kidney pyelectasis.  without symptoms of UTI. All pregnant women had been categorized into three groups according to the degree of pyelectasis as: 1.Grade 1 correlates with renal pelvicalyceal volume up to 10 cm3. 2.Grade 2 correlates with renal pelvicalyceal volume of between 10 and 20 cm3. 3.Grade 3 correlates with renal pelvicalyceal volume of over 20 cm3 . All cases had been send for midstream urine analysis and urine culture to evaluate for the presence of significant asymptomatic bacteriuria then correlate the result with the degree of pyelectasis. Study group 48 patients as considered with SABU while patients without SABU are considered control group. Result: There was a statically significant increment in the presence of significant asymptomatic bacteriuria along with increase in the degree of pyelectasis. Patients with grade 1 pylectasis 31% of control group versus 6.3% study group had significant asymptomatic Bacteriuria ,33.3% of control versus 33.3% of significant study group had grade 2 pyelectasis and 35.7% of control versus 60.4% of significant asymptomatic bacteriuria group had grade 3 pyelectasis. Pyelectasis had positive correlation with the progress of gestation and age of mother. Conclusion: Pyelectasis of the right kidney during antenatal care can help in the diagnosis of significant asymptomatic bacteriuria and future symptomatic urinary tract infection.