Serial qualitative maternal nephrosonography in pregnancy

Abstract

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.

Obstetric Nephrology

“…In parallel, increments in renal hemodynamic function are notable, and renal vascular and tubular responsiveness to circulating hormones is altered (2). In addition, dilation of the urinary collecting system-calices, renal pelvis, and ureterscan be appreciated with ultrasonography (3,4). These adjustments are not only critical to fetal and maternal well being, but also provide the clinical context for detecting gestational aberrations in renal function and electrolyte balance.…”

Changes in Kidney Volume during Pregnancy in Non-Diabetic and Diabetic Rats Measured by Magnetic Resonance Imaging

“…Changes in renal volume in human pregnancy have previously been characterized by ultrasonography [1, 2]. During normal pregnancy in humans, Ciectak and Newton [1] demonstrated a great incidence of hydronephrosis during the 2nd trimester, an observation that was suggested to contribute to the gradual increase in renal size seen during the 2nd and 3rd trimesters.…”

“…Until now only few studies have been published on changes in renal volume during normal pregnancy [1, 2] and during pregnancy in diabetic patients [3, 4, 5]. It seems evident, however, that in normal pregnancy a gradual increase in kidney volume and function occurs, reaching a maximum during the 3rd trimester, with complete normalization after delivery [1, 2].…”

“…It seems evident, however, that in normal pregnancy a gradual increase in kidney volume and function occurs, reaching a maximum during the 3rd trimester, with complete normalization after delivery [1, 2]. In patients having insulin-dependent diabetes mellitus (IDDM), the changes in renal volume and function seem to be dependent on the diabetes duration and the degree of diabetic complications [3, 4, 5].…”

“…In patients having insulin-dependent diabetes mellitus (IDDM), the changes in renal volume and function seem to be dependent on the diabetes duration and the degree of diabetic complications [3, 4, 5]. The changes in renal volume during pregnancy in non-diabetic and diabetic subjects have been characterized by ultrasonography [1, 2, 5], and accordingly no results have been published on changes occurring specifically in renal cortex and medulla. In order to elucidate some of the morphological and biochemical renal changes during pregnancy, interest has turned to pregnancy in rats.…”