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- W4200181711 abstract "Pyelonephritis is a leading cause of infection during pregnancy. Data is lacking regarding clinical utility of various diagnostic findings to predict presence and severity of pyelonephritis in pregnancy. We sought to determine the ability of vital signs, physical exam, and laboratory data to predict adverse outcomes due to pyelonephritis in our obstetric population. A retrospective cohort study was conducted of pregnant patients admitted with pyelonephritis from 10/1/2015-8/31/2020. Patient records were utilized to obtain vital sign and laboratory data as well as to characterize presence and duration of costovertebral angle tenderness (CVA). Patients were categorized as those with or without maternal adverse outcomes (MAO). MAO is comprised of ³ 1 of the criteria as defined in Tables 1 and 2. Continuous data was analyzed with Wilcoxon Rank-Sum Test. Categorical variables were analyzed by Fisher’s Exact Test. Sensitivity and specificity, positive and negative predictive values, and likelihood ratios with 95% confidence intervals were calculated for detection of MAO by specified exam and laboratory data as seen in Table 2. 88 patients met inclusion criteria (Table 1). 31.8% had MAO. 75.0% with MAO had fever as compared to 71.7% without MAO. The duration of fever was increased by 1 day for those with MAO. Admit temperature was decreased for those with MAO, whereas maximal temperature was increased. 78.6% with MAO had CVA tenderness compared to 80.0% of those without MAO. The duration of CVA tenderness and values for MAP, heart rate, and WBC were not predictive of MAO. Whereas procalcitonin was more sensitive, lactic acid was more specific for MAO. Combining lactic acid with procalcitonin increases specificity of procalcitonin for MAO. Admission temperature and elevated lactic acid or procalcitonin levels are clinically useful in distinguishing patients with MAO due to pyelonephritis in pregnancy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
- W4200181711 created "2021-12-31" @default.
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- W4200181711 date "2022-01-01" @default.
- W4200181711 modified "2023-09-27" @default.
- W4200181711 title "Diagnostic Findings Predictive of Maternal Adverse Outcomes Due to Pyelonephritis" @default.
- W4200181711 doi "https://doi.org/10.1016/j.ajog.2021.11.1228" @default.
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