US of the abdomen is safe in pregnancy and is rapid and portable and does not require the use of contrast material [8]. US is often used as a screening examination in pregnancy, is sensitive and specific test for diagnosing hydronephrosis, and does not expose the patient or fetus to ionizing radiation [49,50]. Acute Pyelonephritis Physiologic hydronephrosis of pregnancy occurs in >80% of pregnant patients in the second and third trimester; therefore, hydronephrosis alone is not a reliable sign of APN in pregnant patients [51]. Furthermore, US has a low detection rate of APN and renal abscess [10,36-38]. US Color Doppler Kidneys and Bladder Retroperitoneal There is no current literature specific to the use of US color Doppler of the kidneys, bladder, and retroperitoneum in the evaluation of suspected APN in pregnant patients. US of the kidney, ureters, and bladder is safe in pregnancy, is rapid and portable, and does not require the use of contrast material [8]. US is often used as a screening examination in pregnancy, is sensitive and specific test for diagnosing hydronephrosis, and does not expose the patient or fetus to ionizing radiation [49,50]. Use of color Doppler has been shown to increase sensitivity for detection of APN compared to US with grayscale imaging [40-42]. Physiologic hydronephrosis of pregnancy occurs in >80% of pregnant patients in the second and third trimester; therefore, hydronephrosis alone is not a reliable sign of APN in pregnant patients [51]. Furthermore, US has a lower detection rate of APN and renal abscess than CT [10,36-38]. Variant 5: Suspected acute pyelonephritis. History of pelvic renal transplant with native kidneys in situ and no other complications (eg, no history of pyelonephritis, diabetes, history of stones or renal obstruction, prior renal surgery, advanced age, vesicoureteral reflux, lack of response to therapy, or pregnancy). Initial imaging. Some local practice patterns do not routinely give IV contrast agents to patients with renal transplants.
Acute Pyelonephritis. US of the abdomen is safe in pregnancy and is rapid and portable and does not require the use of contrast material [8]. US is often used as a screening examination in pregnancy, is sensitive and specific test for diagnosing hydronephrosis, and does not expose the patient or fetus to ionizing radiation [49,50]. Acute Pyelonephritis Physiologic hydronephrosis of pregnancy occurs in >80% of pregnant patients in the second and third trimester; therefore, hydronephrosis alone is not a reliable sign of APN in pregnant patients [51]. Furthermore, US has a low detection rate of APN and renal abscess [10,36-38]. US Color Doppler Kidneys and Bladder Retroperitoneal There is no current literature specific to the use of US color Doppler of the kidneys, bladder, and retroperitoneum in the evaluation of suspected APN in pregnant patients. US of the kidney, ureters, and bladder is safe in pregnancy, is rapid and portable, and does not require the use of contrast material [8]. US is often used as a screening examination in pregnancy, is sensitive and specific test for diagnosing hydronephrosis, and does not expose the patient or fetus to ionizing radiation [49,50]. Use of color Doppler has been shown to increase sensitivity for detection of APN compared to US with grayscale imaging [40-42]. Physiologic hydronephrosis of pregnancy occurs in >80% of pregnant patients in the second and third trimester; therefore, hydronephrosis alone is not a reliable sign of APN in pregnant patients [51]. Furthermore, US has a lower detection rate of APN and renal abscess than CT [10,36-38]. Variant 5: Suspected acute pyelonephritis. History of pelvic renal transplant with native kidneys in situ and no other complications (eg, no history of pyelonephritis, diabetes, history of stones or renal obstruction, prior renal surgery, advanced age, vesicoureteral reflux, lack of response to therapy, or pregnancy). Initial imaging. Some local practice patterns do not routinely give IV contrast agents to patients with renal transplants.