Background: Obstructed kidney is also termed hydronephrosis. An obstructed kidney produces buildup of urine within the kidney which increases pressure within the kidney. This condition can be a result of several different causes of which pregnancy is one of them. Obstructed kidneys in pregnancy call for relieving by nephrostomy which is a thin, plastic tube (catheter) that is inserted through the skin on the back and into the kidney. It can relieve a build-up of urine in the kidney and prevents the kidney from being damaged. It drains urine directly from one or both kidneys into a collecting bag outside the body. The bag has a tap so it can be emptied. Aims: To find out the rate of nephrostomy tube insertion in pregnant women in North Manchester General Hospital between January 2009 -December 2013. To identify problems that emanated from insertion of the nephrostomies. Results: Fifteen patients out of 24,863 deliveries (0.06%) in our catchment area underwent 17 nephrostomy procedures. All the nephrostomy insertions were successfully and safely undertaken. There was no immediate complication. The complications that were noted include: subsequent blockage of nephrostomy tubes which required readmission to flush the tubes to render them patent, two nephrostomy tubes subsequently fell out which were replaced, there was 1 minor infection which was treated by oral antibiotics. Surgical causes of obstruction found at post-partum nephrostogram include calculi and ureteric strictures which were managed post-partum. All the pregnancies continued to full-term with delivery of normal full-term babies. Conclusions: Percutaneous nephrostomy insertion in the pregnant woman under ultra-sound scan guidance is a safe and effective procedure associated with minimal complications and this allows pregnancy to continue to full term. The fact that the blocked nephostomies could all be flushed easily to unblock the tubes would indicate that if all district nurses are taught how to carefully flush nephrostomies readmission with blocked nephrostomies would be minimised. Strict adherence to nephrostomy protocol would partly help reduce complications associated with nephrostomy insertion in pregnancy.

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Background: Percutaneous nephrostomy (PCN) is inserted for a variety of causes in women and the associated complications should be known by clinicians. Aims:To audit PCN insertions undertaken in women in order to determine the outcome, complications and their management, the age distribution and causes/indications for the procedure. Methods:The PACS and the automated letter systems as well as the laboratory results of the patients were used to obtain the relevant data.Results: Two hundred and seventeen patients underwent 344 PCN insertions with 100% success, 19 patients had 30 complications. No significant hemorrhage developed with 0.9% moderates and minor hemorrhages which settled. There was no death and no severe sepsis. The ages ranged from 17 to 95 years. Nephrostomy tube blockage occurred in 11(3%) patients. The nephrostomy tube fell-out and were replaced in 7(2%). One case of UTI was encountered. There most common indications for the PCN insertions were urinary tract calculi, transitional cell carcinoma of bladder, cervical carcinoma, urosepsis, pyonephrosis, and pregnancy.Conclusions: PCN insertion can be carried out safely in women of all ages including very old patients. The complication rate in our experience is low. Radiology departments should have trained radiologists capable of inserting nephrostomies.