Early diagnosis and management of maternal ureterohydronephrosis during pregnancy

Ciciu, Elena; Pașatu-Cornea, Ana-Maria; Petcu, Lucian Cristian; Tuţă, Liliana-Ana

doi:10.3892/etm.2021.10949

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…It can follow the ureteric dilatation to the site of obstruction either with stones or ureteric compression by the gravid uterus (3,5).…”

Section: Discussionmentioning

confidence: 99%

“…The degree of hydronephrosis was graded into grade1 minimal hydronephrosis, grade11 mildly dilated renal pelvis with non dilated calyces, grade111 moderately dilated renal pelvis with dilated calyces, grade 1V markedly dilated renal pelvis and calyces with attenuated parenchymal thickness (3).…”

Section: Methodsmentioning

confidence: 99%

“…The right side is affected in almost 85% of cases due to the gravid uterus compressing the right ureter (2).It commences at 20 weeks of gestation and progresses as pregnancy continues, becoming more noticeable during the third trimester (3).…”

mentioning

confidence: 99%

“…Many imaging modalities can help to diagnose the cause of acute renal pain in conjunction with laboratory tests, among the imaging modalities, ultrasonography is considered safe, available and cheap diagnostic modality. The risks of radiation exposure and hazards to the foetus are associated with both computed tomography and conventional X-rays (3,5).…”

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confidence: 99%

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The use of ultrasound in assessing acute renal pain caused by pregnancy

Youssef,

Elkady

2024

Preprint

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Introduction: Acute renal pain or renal colic is an abdominal emergency that can occur during pregnancy and have severe maternal and foetal adverse effects. Ultrasonography can help to evaluate for the cause of renal pain either obstructive or non-obstructive. It can help to localize the site of obstruction and can accurately estimate the size of stones. Aim of the work: The purpose of this study was to evaluate and assess the prevalence of various etiologies that could lead to acute renal pain during pregnancy among our study group using ultrasound. Methodology:Observational retrospective study in which 87 pregnant females attended to a private ultrasound clinic, all were complaining of severe back pain, their age ranged from 18 to 38 years with the mean age being 28 years. All were subjected to abdominal and obstetric ultrasound exams in addition to clinical and laboratory evaluation. Results: There were 87 pregnant women who experienced acute renal pain. 84 patients presented with hydronephrotic changes and 3 patients showed no dilation of pelvicalyceal systems. Among them hydroureteronephrosis with secondary pyeloureteritis observed in 65cases (75%). Renal stones were detected in 22 cases and 1 case was detected with adult polycystic kidney disease. Conclusion :To evaluate the etiology of renal pain during pregnancy and guide management options, ultrasound is a useful and safe imaging modality. Management of acute renal pain with pregnancy is essential to prevent obstetric or maternal complications, it can be conservative medical and expectant in many cases, with few cases may recommend surgical intervention.

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“…It can follow the ureteric dilatation to the site of obstruction either with stones or ureteric compression by the gravid uterus (3,5).…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The use of ultrasound in assessing acute renal pain caused by pregnancy

Youssef,

Elkady

2024

Preprint

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“…The mean duration of the hospitalization was 5.19 ± 1.98 days. We must emphasize that all procedures of double-J insertion were made in an emergency regime due to the known fact that lumbar pain secondary to physiologic ureteral obstruction, symptomatic lithiasis, and ascending urinary infections carry a higher risk for poor maternal and fetal outcomes [ 34 , 35 , 36 ]. We preferred to rapidly solve the urinary stasis and avoid the prolonged conservative approach reported in other studies [ 37 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes in a Cohort of Patients Who Underwent Double-J Ureteric Stenting—A Single Center Experience

et al. 2022

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Background and Objectives: Minimally invasive procedures, such as double-J ureteric stenting, could be a promising therapeutic alternative to conservative management of obstructive urinary tract pathology. We aimed to evaluate the safety and effectiveness of double-J ureteric stenting in pregnant women with ureterohydronephrosis or urolithiasis, along with their infectious complications, and to assess the pregnancy outcomes of this cohort of patients in comparison with a control group. Materials and Methods: This observational retrospective study included 52 pregnant patients who underwent double-J ureteric stenting for urologic disorders in the Urology Department of ‘C.I. Parhon’ University Hospital, and who were followed up at a tertiary maternity hospital- ‘Cuza-Voda’, Iasi, Romania. The control group (63 patients) was randomly selected from the patient’s cohort who gave birth in the same time frame at the maternity hospital, without urinary pathology. Clinical, sonographic, and laboratory variables were examined. Descriptive statistics, non-parametric tests, and a one-to-one propensity score-matched analysis were used to analyze our data. Results: The univariate analysis indicated a significant statistical difference between the control group and the interventional group regarding maternal age (p = 0.018), previous maternal history of renal colic (p = 0.005) or nephrolithiasis (p = 0.002). After applying the propensity score-matched analysis, cesarean delivery rates (p < 0.001), preterm labour (p = 0.039), premature rupture of membranes (p = 0.026), preterm birth rates (p = 0.002), and post-partum UTI rates (p = 0.012) were significantly different between the control group and the matched treatment group. Ureterohydronephrosis, whether simple (n = 37; 71.2%) or infected (n = 13; 25%), was the main indication for double-J ureteric stenting. Complications such as pain (n = 21; 40.3%), stent migration (n = 3; 5.76%) or encrustation (n = 2; 3.84%), as well as reflux pyelonephritis (n = 2; 3.84%) and gross hematuria (n = 1; 1.92%) were recorded during follow-up. Conclusions: Our results show that double-J stenting is a safe and effective treatment option for pregnant patients with obstructive urological disorders.

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