mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2021-12-3-22-31mvjr-1453Research ArticleОБЗОРЫREVIEWБессимптомная бактериурия и пиелонефрит при беременностиAsymptomatic bacteriuria and pyelonephritis during pregnancyhttps://orcid.org/0000-0002-0937-4573НабокаЮ. Л.NabokaY. L.

Набока Юлия Лазаревна, д.м.н., проф., заведующая кафедрой микробиологии и вирусологии №1

Ростов-на-Дону

Yulia L. Naboka, Dr. Sci. (Med.), Professor, head of Department of microbiology and virology №1

Rostov-on-Don

nagu22@mail.ruРымашевскийА. Н.RymashevskyA. N.

Рымашевский Александр Николаевич, д.м.н., проф., заведующий кафедрой акушерства и гинекологии №1

Ростов-на-Дону

Alexander N. Rymashevsky, Dr. Sci. (Med.), professor, Head of the Department of Obstetrics and Gynecology No. 1

Rostov-on-Don

rymashevskyan@mail.ruКоганО. М.KoganO. M.

Коган Ольга Михайловна, к.м.н., заведующая отделением гинекологии, руководитель Центра «Женское Здоровье», главный акушер-гинеколог

Ростов-на-Дону

Olga M. Kogan, Cand. Sci. (Med.), head gynecology division, leader «Women’s Health» centre, chief gynecologist

Rostov-on-Don

olga.kogan.71@mail.ruhttps://orcid.org/0000-0003-0995-7848ГудимаИ. А.GudimaI. A.

Гудима Ирина Александровна, д.м.н., доц., профессор кафедры микробиологии и вирусологии №1

Ростов-на-Дону

Irina A. Gudima, Dr. Sci. (Med.), associate professor, professor of the Department of microbiology and virology №1

Rostov-on-Don

naguirina22@gmail.comВоробьеваН. В.VorobyevaN. V.

Воробьева Наталья Викторовна, врач акушер-гинеколог родильного отделения, научно-исследовательский институт акушерства и педиатрии

Ростов-на-Дону

Natalia V. Vorobyeva, obstetrician gynecologist the scientifi c research institute for obstetrics and pediatrics

Rostov-on-Don

nensi71@mail.ruАлькинаА. К.AlkinaA. K.

Алькина Анна Константиновна, Ростовский государственный медицинский университет

Ростов-на-Дону

Anna K. Alkina

Rostovon-on-Don

alkinann@yandex.ruРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationРостовская Клиническая Больница Южного Окружного Медицинского Центра ФМБАРоссияRostov Clinical Hospital of the Southern District Medical CenterRussian FederationРостовский государственный медицинский университетРоссияRostov State Medical University, Rostov-on-DonRussian Federation2021300920211232231Copyright © Набока Ю.Л., Рымашевский А.Н., Коган О.М., Гудима И.А., Воробьева Н.В., Алькина А.К., 20212021Набока Ю.Л., Рымашевский А.Н., Коган О.М., Гудима И.А., Воробьева Н.В., Алькина А.К.Naboka Y.L., Rymashevsky A.N., Kogan O.M., Gudima I.A., Vorobyeva N.V., Alkina A.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1453

К наиболее распространённой экстрагенитальной патологии во время беременности относят инфекции мочевых путей (ИМП) различной локализации, которые при отсутствии лечения могут приводить в некоторых случаях к развитию акушерской, урологической и перинатальной патологий. Предрасполагающими факторами к манифестации ИМП могут являться повышенный прогестерон, замедленная перистальтика, застой мочи в мочеточниках, рост матки, смещение мочевого пузыря и увеличение объема остаточной мочи. Во время беременности бессимптомная бактериурия (ББ) может повышать риск развития пиелонефрита и последующих осложнений со стороны матери и плода. Беременные должны проходить обследование на ББ минимум один раз в начале беременности (после 14 недель). В 70 – 95% эпизодов ИМП у беременных, E.coli является доминирующим уропатогеном. Основным методом лечения ББ и гестационного пиелонефрита (ГП) у беременных является антибиотикотерапия (АБТ), которая в большинстве случаев назначается эмпирически. В настоящее время отсутствует консенсус как в отношении выбора антимикробного препарата (АМП), так и продолжительности лечения при ИМП у беременных. При отсутствии эффекта от проводимой консервативной терапии при обструктивном пиелонефрите у беременных необходимо своевременно решать вопрос о дендрировании верхних мочевых путей (ВМП).

The most common extragenital pathology during pregnancy is urinary tract infection (UTI) of various localization. In some cases, untreated UTI can contribute to the development of obstetric, urological, and perinatal pathologies. Factors predisposing to the UTI manifestation may include increased progesterone, delayed peristalsis, urine retention in the ureters, uterine growth, bladder displacement, and increased residual urine volume. Asymptomatic bacteriuria (ASB) during pregnancy can increase the risk of pyelonephritis and subsequent maternal and fetal complications. Pregnant women should be screened for ASB at least once at the beginning of pregnancy (aft er 14 weeks). E.coli is the dominant uropathogen in 70 – 95% of UTI cases in pregnant women. The main treatment for ABT and pyelonephritis in pregnancy (PiP) is antibiotic therapy (ABT), which is prescribed empirically in most cases. There is currently no consensus on the choice of ABT and the duration of treatment for UTI in pregnant women. In the case of ineff ective drug therapy of PiP, it is necessary to raise the issue of the upper urinary tract drainage promptly.

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The authors declare that there are no conflicts of interest present.