Physiologic parameters and severe maternal morbidity in acute pyelonephritis

ObjectiveThis study aimed to evaluate vital parameters related to severe maternal morbidity due to acute pyelonephritis. MethodsRetrospective cross-sectional study of in-hospital cases under acute pyelonephritis treatment allocated as improvement in ward or Intensive Care Unit (ICU) admission from January 2014 to December 2018. Vital data were compared regarding means and predetermined abnormal parameters from warning systems described in literature, statistically significance considered p<0.05. Odds Ratio (OR) with 95% confidence intervals (95% CI) were estimated to examine the effect of the variables on Intensive Care Unit admission.ResultsWe studied 335 cases, no deaths recorded and a 5.9% rate (n=20) of Intensive Care Unit admission; these were younger (22.0±4.8 vs. 24.6±5.3 years; p=0.022) and more frequently in their first pregnancy (55% vs. 9.8%; p<0.001). There was significant difference between groups regarding heart rate (HR), blood oxygen saturation (SpO2) and respiratory rate (RR) means; under the abnormal classification, these were the most prevalent parameters in the ICU group.Cases were more likely admitted to ICU when HR ≥100bpm (OR=30.5, 95% CI 8.6–108.1), diastolic blood pressure (DBP) <50mmHg (OR=16.4, 95% CI 5.3–50.0) and RR≥22bpm (OR=13.4, 95% CI 4.8–37.3). Critical interventions in ICU cases accounted for 65% (n=13) mechanic ventilation, 40% (n=08) of vasopressors administration and 25% (n=05) of hemotherapy. ConclusionAltered HR, RR and SpO2 were the most frequent variables in ICU admission group and HR≥100bpm, DBP<50mmHg and RR≥22bpm were the parameters more likely associated to this outcome.