Risk factors of uterine contraction after ureteroscopy in pregnant women with renal colic

Abstract

Background Ureteroscopy is widely applied in pregnant women with renal colic, but such patients are easy to experience uterine contraction after surgery. There are many factors which may affect uterine contraction, this study aims to explore the risk factors of uterine contraction triggered by ureteroscopy in pregnant women with renal colic. Methods One hundred and one pregnant women were retrospectively analyzed, the patients were hospitalized because of severe renal colic. All patients received ureteroscopy during which double J catheters were inserted into ureters for drainage. Patients received other medical treatments individually according to their condition and uterine contractions were detected by EHG within 12 h after operation. Patients were classified as group A (uterine contraction) and group B (no uterine contraction) according to the presence or absence of continuously regular uterine contraction. Clinical characteristics were collected for further analysis, including history of childbirth, anesthesia method, application of phloroglucinol or not, operation time, Oxygen inhalation or not, pain relief or not after surgery, systemic inflammatory response syndrome (SIRS) occurred or not. A binary logistic regression analysis model was established to explore whether such clinical characteristics were relevant to uterine contraction after ureteroscopy. Results Continuously regular uterine contraction presented in 46 pregnant women within 12 h after ureteroscopy, making the incidence of uterine contraction as high as 45.54%. The presence of uterine contraction was related to the following factors(P < 0.05): history of childbirth (primipara versus multipara)(OR 6.593, 95% CI 2.231–19.490), operation time (each quarter additional) (OR 2.385, 95% CI 1.342–4.238), application of phloroglucinol (yes versus not) (OR 6.959, 95% CI 1.416–34.194), pain relief after surgery(yes versus not)(OR 6.707, 95% CI 1.978–22.738), SIRS occurred after surgery (yes versus not) (OR 0.099, 95% CI 0.014–0.713). Conclusion Continuously regular uterine contraction is easy to occur within 12 h after ureteroscopy in pregnant women. SIRS occurred after surgery is a risk factor for uterine contraction; on the contrary, no history of childbirth, shorter operation time, application of phloroglucinol, pain relief after surgery are protective factors.

Preference for diagnosing and treating renal colic during pregnancy: a survey among Chinese urologists

“…Phloroglucinol is a highly selective drug that is released in abnormal spastic smooth muscle, and effectively relieves abnormal uterine contraction and ureteral spasm but does not cause malformation of the foetus. Phloroglucinol is widely used for acute abdomen during pregnancy 18 . Progesterone relaxes ureteral smooth muscle and inhibits uterine contractions, and it is often used as the drug of choice for treating urinary calculi during pregnancy.…”

Efficacy and Safety Analysis of Phloroglucinol in Combination with Oxytocin for the Induction of Labor in Women with Term Premature Rupture of Membranes (PROM)

“…Phloroglucinol is a myotropic antispasmodic drug that acts directly on the smooth muscle of the genitourinary tract and the gastrointestinal tract while having little impact on normal smooth muscle [ 12 ]. It has been extensively employed in recent years to enhance cervical ripening and softening, with promising outcomes [ 13 , 14 ]. However, more studies are required to determine the efficacy and safety of its combined oxytocin in the induction of labor with the term PROM.…”