Acute Renal Failure due to Bilateral Ureteral Obstruction by the Pregnant Uterus

Abstract

We report a case of post-renal insufficiency in the 26th week of a normal pregnancy; the cause being bilateral ureteral obstruction by the pregnant uterus. By placing double-J-catheters in both ureters the patient was able to continue pregnancy to term. The catheters were removed 1 week postpartum.

Symptomatic Physiologic Hydronephrosis in Pregnancy

“…If left untreated, it can result in severe renal infection and urinary sepsis that may threaten the life of either the mother or the baby. Hydronephrosis manifested by acute pain, refractory urosepsis or even renal failure has been reported [6, 17, 18, 19]and is considered pathologic.…”

Urologic Issues During Pregnancy

“…Painful hydronephrosis of pregnancy is conventionally treated by having the patient remain situated to the left in order to relieve ureteral pressure induced by the dextrorotated uterus (fig 1a, 1b). When this measure fails, ureteral stenting or establishment of percutaneous drainage are effective in pain relief and preventing evolution of hydronephrosis to spontaneous renal rupture (28)(29)(30)(31)(32). Alternative resolutions to the problem of symptomatic gestational hydronephrosis include induction of labor and delivery (33,34), and epidural block (35).…”