This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: recent papers  obst, Subject name: Gynaecology & Obstetrics
[{'content': 'Acute pyelonephritis in pregnancy most often complicates _______ \nSelect and explain. \nA. 1st trimester, B. 2nd trimester, C. 3rd trimester, D. Puerperium', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Acute pyelonephritis in pregnancy most often complicates 2nd trimester of pregnancy. Acute Pyelopnephritis: Most common in the second trimester, in nulliparous individual of young age. Most common organism: E.coli >> Streptococcus, S.aureus > Enterobacter, Klebsiella Occurs more commonly in those with preexisting renal disease Symptoms and signs: Fever with chills, loin pain and vomiting. Renal angle tenderness may be present. Usually unilateral and more common on the right side. patients may develop acute respiratory distress syndrome due to endotoxin-mediated alveolar injury and hemolysis due to endotoxins leadinng to anemia. Management: Intravenous hydration, antibiotics Ref: Williams Obstetrics 25th edition Pgno: 1028', 'role': 'assistant'}]