Thirty-four pregnant primigravidae underwent serial real-time nephrosonography during their pregnancy and for three months post partum. The study confirms the asymmetrical effect of pregnancy on upper urinary tract dilatation as well as the incidence of changes as reported by others. Unlike previous published work, the serial nature of this study makes it the first to describe in detail the degree of change which occurs with advancing gestation and allows the study of the dynamics of pregnancy hydronephrosis. It demonstrates that twenty weeks of gestation marks the threshold for the development of significant dilatation and shows a long-term effect of pregnancy on the distensibility of the upper urinary tract.
Real time ultrasound provides a quick, safe and convenient method of examining not only the appearance but also the dimensions of the kidneys and the upper renal tract in pregnant women. Using an on-screen measuring system, the length, width and thickness of the renal and pelvicalyceal outline of both left and right kidney were measured in a non-pregnant control group, and also at regular intervals throughout pregnancy and into the puerperium in a group of healthy primigravid patients. From the results the behaviour of the total renal pelvicalyceal and renal parenchymal volumes can be followed. Furthermore they clearly illustrate the separate and independent influences on the pregnant maternal upper renal tract of urinary stasis, increased renal blood flow, and possibly cellular hypertrophy.
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