Abstract. This article examines modern approaches to predicting the development of preeclampsia and implementing preventive measures in pregnant women with chronic pyelonephritis. The study assessed the clinical significance of maternal blood pressure, urinary protein levels, renal function, recurrent urinary tract infections, and fetal-placental monitoring during pregnancy. The findings indicate that recurrent urinary tract infections, deterioration of renal function, proteinuria, and progressive elevation of blood pressure may be associated with an increased risk of preeclampsia in pregnant women with chronic pyelonephritis. Individual risk stratification and regular antenatal monitoring may contribute to earlier identification of high-risk patients and timely implementation of preventive and therapeutic measures. Continuous assessment of maternal renal status and fetal-placental condition is particularly important for reducing the risk of maternal and perinatal complications. The results support an individualized approach to the management of pregnancy complicated by chronic pyelonephritis and emphasize the importance of early risk assessment and systematic maternal-fetal surveillance.