Effect of osteopathic correction on urodynamic parameters in pregnant women with chronic pyelonephritis

Introduction. The course of pregnancy in women with chronic pyelonephritis is associated with a high risk of exacerbation of the underlying disease, which is accompanied by impaired urine flow. This complicates pregnancy and increases the likelihood of purulent-septic complications during the perinatal period. Long-term use of antibacterial drugs to treat or prevent complications may adversely affect fetal development and increase the risk of allergic reactions in pregnant women. Additionally, the use of instrumental methods for renal pelvis drainage (e. g., ureteral stenting) carries a high risk of postoperative complications and stent-associated symptoms in 80 % of women, which are difficult to manage during pregnancy due to contraindications for pharmacological therapies. Managing pregnancy in women with chronic pyelonephritis requires a multidisciplinary approach to prevent complications and reduce perinatal risks for both mother and fetus. This necessitates the search for nonpharmacological methods to improve urodynamics.
The aim of the study: to evaluate the effect of osteopathic correction on urodynamic parameters in pregnant women with chronic pyelonephritis.
Materials and methods. In a prospective controlled randomised study conducted between January 2018 and January 2024 on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy», 180 pregnant women with chronic pyelonephritis without renal failure aged 25–45 years, whose gestational age was 13–27 weeks, were included. All pregnant women with chronic pyelonephritis, depending on the correction technique used, were divided into three groups using a random number generator: the main group (60 patients) and two control groups of 60 patients each. Patients of the main group received standard drug therapy and osteopathic correction (3 procedures with an interval of 10–14 days). Patients in the first control group received standard drug therapy according to approved clinical recommendations. Patients in the second control group, along with drug therapy, used physical exercises 2 times a week for 1,5 months, as prescribed by a physical therapy doctor. In all pregnant women, before the beginning and after completion of correction, osteopathic examination was performed with the formation of an osteopathic report and the size of the renal calyx-lochanous system was assessed by ultrasound.
Results. Osteopathic correction, when combined with standard drug therapy, demonstrated statistically greater improvement in urodynamics compared to isolated drug therapy or drug therapy combined with therapeutic exercises. This was evidenced by a reduction in renal calyceal-pelvic system dimensions on ultrasound (p<0,01).
Conclusion. Incorporating osteopathic correction into the comprehensive treatment of chronic pyelonephritis in pregnant women significantly improves urodynamic parameters. These findings may contribute to optimizing medical care for this patient population.

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