Maternal Physiologic Renal Pelvis Dilatation in Pregnancy

Wadasinghe, Sahan Udayanga; Metcalf, Louisa; Metcalf, Patricia; Perry, David

doi:10.7863/ultra.15.12036

Cited by 5 publications

(13 citation statements)

References 12 publications

(33 reference statements)

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“…Further observation of dilatations on the right side and twin pregnancies also supports this hypothesis (4). In addition, the crossing of the ureter by the ovarian vein at the pelvic brim on the right while running parallel on the left, dextrorotation of the uterus, and the relative protection of the left ureter provided by the sigmoid colon are also possible factors (2,4,18). As a matter of fact, maternal hydronephrosis usually improves spontaneously after delivery because the compression of the uterus is removed after birth (19,20).…”

Section: Introductionsupporting

confidence: 67%

“…Therefore, maternal pathological obstructive hydronephrosis cases should be differentiated from maternal physiological dilatations. For this purpose, some authors suggest the use of the term "physiological maternal renal pelvic dilatation" to avoid the pathological connotations of the term maternal hydronephrosis (4). According to the literature, the rate of symptomatic maternal hydronephrosis is 0.2-3% (1,(5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

“…Maternal upper urinary tract dilatations, which are considered physiologically normal, are mostly observed on the right side. It usually develops after the mid-gestation (4,(15)(16)(17)(18)(19). Urinary dilatation in pregnant women is explained by the effect of progesterone on the smooth muscle of the urinary system and the compression of the expanding uterus into the ureter (2,4,18,20).…”

Section: Introductionmentioning

confidence: 99%

“…Urinary dilatation in pregnant women is explained by the effect of progesterone on the smooth muscle of the urinary system and the compression of the expanding uterus into the ureter (2,4,18,20). Further observation of dilatations on the right side and twin pregnancies also supports this hypothesis (4). In addition, the crossing of the ureter by the ovarian vein at the pelvic brim on the right while running parallel on the left, dextrorotation of the uterus, and the relative protection of the left ureter provided by the sigmoid colon are also possible factors (2,4,18).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, maternal nephrosonography findings during pregnancy were quantitatively and qualitatively documented years ago (15,16). Ultrasonographic evaluation has been the mainstay of obstetric imaging for many years (4). Maternal hydronephrosis can be detected with abdominal US from the beginning of the second trimester of pregnancy (23).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women

Bayraktar

Kahraman

Alaç

et al. 2021

Arch Ital Urol Androl

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Purpose: The aim of this study is to determine the proportion of maternal hydronephrosis and symptomatic cases requiring treatment in pregnant women without ureteral stones and the characteristics of these cases. Materials and methods: Between February 2018 and April 2019, all pregnant women followed for pregnancy in obstetrics and outpatient policlinic were evaluated prospectively. Maternal hydronephrosis rate, degree of hydronephrosis and side, symptomatic hydronephrosis rate, maximum renal anteroposterior diameter of renal pelvis and visual analogue scale were detected. Symptomatic patients were treated conservatively or surgically. Findings in both treatment groups were analyzed by t-test or Chi-squared test. Pearson or Spermean’s tests were used for correlation analyzes. Results: A total of 1026 pregnant women aged 18-45 (27.7 ± 5.2 years) were followed prospectively. The rate of maternal hydronephrosis was 28.7% and the rate of symptomatic hydronephrosis was 4.7%. Of the patients with symptomatic hydronephrosis, 73.4% (3.5% of total) were treated conservatively and 26.5% (1.3% of total) were treated surgically. There was a positive correlation between hydronephrosis and gestational week (p < 0.001), visual analogue scale (p < 0.001) and hematuria (p < 0.05). There was a negative correlation between hydronephrosis and maternal age (p < 0.05) and number of pregnancies (p < 0,001). The anteroposterior diameter of renal pelvis (p < 0.001), visual analogue scale (p < 0.05) and fetal body weight values (p < 0.05) on the right side were higher in the surgical treatment group than the conservative group. Conclusions: The majority of cases with maternal hydronephrosis in pregnant women without ureteral stones are asymptomatic. Most symptomatic cases can also be treated conservatively. In cases requiring surgical treatment (1.3%), fetal body weight, visual analogue scale and anteroposterior renal pelvis diameter are higher.

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Section: Introductionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women

Bayraktar

Kahraman

Alaç

et al. 2021

Arch Ital Urol Androl

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Kidney morphology in pregnancy using T2-weighted MRI

Conti-Ramsden¹,

Hill²,

Rutherford³

et al. 2022

Clinical Radiology

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Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

Scurt

Morgenroth

Bose

et al. 2022

Geburtshilfe Frauenheilkd

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Despite significant improvements in inpatient and outpatient management, pregnancy-related acute kidney injury (Pr-AKI) remains an important risk factor for early and late maternal and fetal morbidity and mortality. There is a discrepancy between the incidence of Pr-AKI in developing and in developed countries, with the former experiencing a decrease and the latter an increase in Pr-AKI in recent decades. Whereas septic and hemorrhagic complications predominated in the past, nowadays hypertensive disorders and thrombotic microangiopathy are the leading causes of Pr-AKI. Modern lifestyles and the availability and widespread use of in-vitro fertilization techniques in industrialized countries have allowed more women of advanced age to become pregnant. This has led to a rise in the percentage of high-risk pregnancies due to the disorders and comorbidities inherent to or accompanying aging, such as diabetes, arterial hypertension and preexisting chronic kidney disease. Last but not least, the heterogeneity of symptoms, the often overlapping clinical and laboratory characteristics and the pathophysiological changes related to pregnancy make the diagnosis and management of Pr-AKI a difficult and challenging task for the treating physician. In addition to general supportive management strategies such as volume substitution, blood pressure control, prevention of seizures or immediate delivery, each disease entity requires a specific therapy to reduce maternal and fetal complications. In this review, we used the current literature to provide a summary of the physiologic and pathophysiologic changes in renal physiology which occur during pregnancy. In the second part, we present common and rare disorders which lead to Pr-AKI and provide an overview of the available treatment options.

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Maternal Physiologic Renal Pelvis Dilatation in Pregnancy

Abstract: We present sonographic reference data for asymptomatic pregnancy-related renal pelvis dilatation in singleton pregnancies from a large cohort of women.

Cited by 5 publications

References 12 publications

Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women

Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women

Kidney morphology in pregnancy using T2-weighted MRI

Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management

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