Relevance of the issue. High prevalence of pyelonephritis (up to 10%) in pregnant women is an acute problem. The issues of pathogenesis, early diagnosis, prevention of recurrence of the disease remain unsolved. Due to anatomical and physiological changes in the body during pregnancy, urinary tract infection becomes complicated, and effective therapy is especially important. Aim. Optimization of treatment and prevention of recurrent pyelonephritis in pregnant women. Materials and methods. 60 pregnant women with gestational pyelonephritis and acute chronic pyelonephritis, who received standard antibiotic therapy. Additionally, the patients in the main group (n = 30) were prescribed systemic enzyme therapy (Wobenzym). Before and after therapy, all patients underwent Doppler ultrasound examination to determine the blood flow rates in renal and interlobar arteries. Results. The women in both groups were comparable in terms of age, gestation period and clinical characteristics of the disease. Before treatment blood flow indices in renal and interlobar arteries were high in both groups. However, in the group of women, who received Wobenzym, Doppler iindices for blood flow were of normal range in the renal artery (p=0.004) and in the interlobar artery (p=0.001), while standard therapy did not show statistically significant differences. Adding Wobenzym to therapy increased the chances for normalization of the blood flow in renal artery by 7 times (95% CI: 1,38–35,5; p=0,01). Systemic enzyme therapy reduced the recurrence of the disease by 4,5 times (95% CI: 1,09–18,5) compared to the comparison group (p=0.0287). Conclusion. Thus, the use of Wobenzym in complex therapy versus standard therapy had a beneficial effect on statistically significant improvement in renal blood flow and a decrease in the frequency of recurrence of the disease.