Urolithiasis and pregnancy

Pyonephrosis: A Rare Cause of Puerperal Pyrexia

“…Thus we too proceeded with the same. Studies show percutaneous drainage to be a fast, trusted and effective diagnostic and therapeutic method as in our case [3]. Giant pyonephrosis is rare in the present era due to the advanced diagnostic methods and modern treatment.…”

“…Renal colic is caused by the distention of the urinary tract and kidney capsule by the stone. In a cohort of pregnant women with symptomatic urinary stones, the authors observed that the most frequent symptoms were back pain (71 %) and hematuria (57.1 %) [3].…”

“…Total abdominal ultrasound (TAS) examination should be the initial image test as it has a high specificity of 90 % for the diagnosis of urolithiasis, but the sensitivity of this method is quite low (11-24 %) [3]. Though TAS may not give a conclusive diagnosis, it can demonstrate indirect signs of obstruction, notably ureterohydronephrosis, the degree of hydronephrosis, absence of ureteral stream or increased renal artery resistivity index [1,3]. If we can add TAS visualization of renal pelvis during second-trimester anomaly scan, lot of the asymptomatic cases can be labeled as high risk of preterm labor.…”

Preterm Delivery in the Setting of Left Calyceal Rupture

“…It is impossible to determine whether her preterm labor and spontaneous delivery were the cause or the result of her calyceal rupture. However, the suspicion for urolithiasis in this patient is significant because there is a 1.4 to 2.4 times increased risk of premature membrane rupture and preterm labor in pregnant women with symptomatic kidney stones [ 7 ]. In a large-scale Canadian study looking at pregnant patients with documented renal calculi, 99% of the calculi occurred in the second or third trimester [ 8 ].…”

“…While analgesia and conservative therapy are appropriate forms of initial management for patients with symptomatic urolithiasis, patients with pain that persists despite analgesia should receive surgical intervention with percutaneous nephrostomy or stenting [ 4 , 7 ]. In our patient, failure of conservative management resulted in plans for placement of a ureteral stent.…”