Acerca de la hidronefrosis sintomática en la gestante

Verdejo, Pedro Navalón; Ballester, Francisco Sánchez; Costa, Y. Pallás; Ivorra, José Antonio Cánovas; Domínguez, Felipe Ordoño; Escudero, Joaquín Juan; Abril, Luis de la Torre; Campos, Macarena Ramos de

doi:10.4321/s0004-06142005001000001

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Por otro lado, la teoría mecánica postula que es producto de la compresión de los uréteres por el útero grávido y los vasos iliacos y gonadales. Dicha dilatación fisiológica se produce en el 90% de las embarazadas, ocurre aproximadamente entre las semanas 6 y 10 de gestación, incrementa en todo el periodo gestacional y desaparece en 4 a 6 semanas del puerperio 10,11,21,22 . Típicamente, la hidroureteronefrosis exhibe un predominio mayor en el lado derecho, que puede deberse a la dextrorrotación uterina y al papel protector que brinda el colon sigmoides al uréter izquierdo por su contenido gaseoso 18,21 .…”

Section: Cambios Anatomofisiológicos Renalesunclassified

“…Del mismo modo, la dilatación del tracto urinario facilita la migración de cálculos renales asintomáticos desde el riñón al uréter, lo que podría explicar la observación de que los cálculos ureterales son dos veces más comunes que los cálculos renales. En la mayoría de los casos, la hidroureteronefrosis gestacional es asintomática y no se asocia con obstrucción significativa; sin embargo, en ocasiones puede resultar en dolor en el flanco e incluso en rotura del fórnix 10,22 .…”

Section: Cambios Anatomofisiológicos Renalesunclassified

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Nefrolitiasis en la paciente gestante: revisión de la literatura

Bohórquez-Rivero¹,

Restom-Arrieta²,

Sáenz-López³

et al. 2024

RECHOG

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La litiasis renal en la paciente gestante es una condición relativamente infrecuente; sin embargo, es la causa más común de dolor no obstétrico durante el embarazo. En el periodo de gestación se producen diversos cambios anatomofisiológicos en el tracto urinario, como la dilatación de los cálices renales, la pelvis renal y los uréteres por causa del efecto que ejerce la progesterona sobre el músculo liso uretral, y la compresión de los uréteres por el útero grávido. Estas modificaciones conducen a un aumento del flujo plasmático renal y de la tasa de filtrado glomerular, ocasionando hiperuricosuria e hipercalciuria. Del mismo modo, durante el embarazo también se produce un aumento de la secreción de inhibidores de cálculos, por lo cual la prevalencia de la formación de cálculos durante el embarazo es similar a la de las mujeres no embarazadas. El bajo índice de sospecha por parte del médico tratante puede entorpecer el diagnóstico y el tratamiento de esta patología, que también son limitados en la gestación debido a los potenciales riesgos teratogénicos. Se realiza una revisión narrativa de la literatura partiendo de la evidencia científica disponible en las diferentes bases de datos y de esta manera se pretende instruir al médico en los aspectos clave de dicho tema.

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Section: Cambios Anatomofisiológicos Renalesunclassified

Nefrolitiasis en la paciente gestante: revisión de la literatura

Bohórquez-Rivero¹,

Restom-Arrieta²,

Sáenz-López³

et al. 2024

RECHOG

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Management of Acute Symptomatic Hydronephrosis of Pregnancy by Postural Drainage

Chitale¹,

Chitale²

2010

TOUNJ

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Introduction & Objectives:Asymptomatic hydronephrosis is found in >90% of pregnant women, only a small proportion become symptomatic. Non-surgical management is the treatment of choice. In refractory cases surgical intervention is indicated.We present our experience with conservative management of acute symptomatic hydronephrosis of pregnancy by facilitating postural drainage of the obstructed symptomatic kidney.Material & Methods: 1750 women with full term pregnancy were managed in the unit over 5 yrs. 130 (7.4%) presented with unilateral loin pain and were in the third trimester of pregnancy at presentation (20@ 28 weeks, 58@ 30 weeks, and 52@ 32 weeks). 68 / 130 (52.3%) were multi-parous. Age range was 26-38 yrs.115 (88.5%) presented with right-sided loin pain and 15 (11.5%) had pain in the left loin. There was no evidence of incipient urinary tract infection (UTI). Ultrasound scan (USS) confirmed presence of ipsilateral mild to moderate hydronephrosis with no evidence of renal / ureteric calculus.All were refractory to routine enteral or parenteral analgesia over 72 hrs.They were managed in a semi-prone position while in bed, with the affected side up and non-dependant. Head end of their bed was kept raised by 10º throughout this period of conservative management; initiated in the hospital and continued at home until term.Results: 121 of the 130 women (93.1%) had symptomatic improvement. None required regular analgesia and went to term without further intervention i.e. insertion of nephrostomy / stenting. Follow-up USS at three months post-partum revealed complete resolution of hydronephrosis.Conclusions: Postural drainage of the kidney is highly effective in the management of acute symptomatic hydronephrosis of pregnancy. In the majority of cases (93%), if used diligently, it will help prevent the need for invasive uro-radiological intervention.

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Pyelonephritis in Pregnancy: modern draining tactics

Левченко

Моргун

2019

Vestn. urol.

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Many publications in foreign and domestic papers are devoted to pyelonephritis in pregnancy. At the same time, aspects of the upper urinary tract (UUT) drainage, indications / lack of indications, and the duration of UUT drainage during kidney infections in pregnant women are bypassed. Etiological treatment of this pathology is well described in the European Association of Urology guidelines and American Urological Associations guidelines in accordance with the recommendations of the Food and Drug Administration (FDA). However, there are no references to the management of patients with UUT dilatation, associated with pyelonephritis in pregnant women. The Russian Clinical Guidelines for Urology (2018) also contains very brief information on this issue. Thus, each urological clinic of the Russian Federation has formed its own views on the draining tactics for pyelonephritis in pregnant women, which our colleagues have been following for years and decades. This publication presents an analysis of the literature sources focusing on the current state of the problem of pyelonephritis in pregnancy and the «neсessity» of the UUP drainage. It is intended to initiate a review of the established «tradition» and avoid a significant number of catheter and stent-related complications.

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Acerca de la hidronefrosis sintomática en la gestante

Cited by 5 publications

References 24 publications

Nefrolitiasis en la paciente gestante: revisión de la literatura

Nefrolitiasis en la paciente gestante: revisión de la literatura

Management of Acute Symptomatic Hydronephrosis of Pregnancy by Postural Drainage

Pyelonephritis in Pregnancy: modern draining tactics

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