Lee, Lucero, Macalintal, Magallanes, Maningas, Ombao, Pacifico
Initial Laboratory Tests CBC leukocytosis Low Hgb, low Hct – bleeding (obstructive uropathy) ESR CRP
Urinalysis Pyuria With bacteriuria (≥10 5 /ml): highly sensitive indicator of UTI Sterile pyuria Atypical organisms: C. Trachomatis, U. Urealyticum, M. Tuberculosis Non-infectious urologic conditions: calculi, anatomic abnormality, nephrocalcinosis, VUR, interstitial nephritis, polycystic disease Gram-stained uncentrifuged urine (for empiric choice of antibiotic) Leukocyte casts which form casts – characteristic of acute pyelonephritis Hematuria – urolithiasis
Serum BUN and Creatinine determine (reversible) renal damage
Two 24-h urine collections calcium, sodium, phosphorus, magnesium, oxalate, uric acid, citrate, sulfate, creatinine, pH, and total volume
Comprehensive Metabolic Panel serum calcium, uric acid, and phosphorus; parathyroid hormone level
Urine culture and sensitivity No longer requested for uncomplicated acute cystitis criterion standard for evaluation of a urinary tract infection (UTI) during pregnancy results are often unavailable at the time of treatment
Blood culture Severely ill patients
Imaging The total dosage of ionizing radiation should not exceed 3-5 rads during the course of pregnancy
UTZ cheap; no exposure to radiation or dyes stones may not be identified due to hydronephrosis in pregnancy typical acoustic shadowing
X-ray one-shot pyelogram (ie KUB) to identify stones obscured in renal ultrasound can deliver rad
Helical CT scan gold standard for urolithiasis in non- pregnant patients
Other Procedures evaluation of fetal status: FHT
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