Urolithiasis in pregnancy

Charalambous, Stavros; Fotas, Asterios; Rizk, Diaa E. E.

doi:10.1007/s00192-009-0920-z

Cited by 31 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The first step in the management of urinary lithiasis or renal colic during pregnancy should be a conservative treatment. Conservative treatment modalities (intravenous hydratation and analgesia) favor a spontaneous stone passage in 4-84 % of pregnant patients [12][13][14]. At present, US is preferred as first-line imaging modality in pregnancy, because it is non-invasive and free from ionizing radiation.…”

Section: Discussionmentioning

confidence: 99%

Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy

Dell’Atti

2014

J Ultrasound

View full text Add to dashboard Cite

Introduction The aim of the present study was to document the role of ultrasound in the diagnosis and management of symptomatic hydronephrosis during pregnancy. Methods In this study, we reviewed 36 consecutive cases of pregnant women whose pregnancy was complicated by symptomatic hydronephrosis. In all patients, management was initially conservative (analgesics and fluids) after hospitalization. The following criteria were used to indicate double-J stent placement under US guidance rather than a conservative treatment: persistent pain with no improvement after conservative treatment, progressive hydronephrosis ([2 cm dilatation of the renal pelvis) or presence of uterine contractions. Results The mean patient's age was 25 years (17-35) and gestational age at clinical presentation was 24 weeks (13-37). 81 % of cases had a renal pelvis dilatation[2 cm, while in only 19 % of cases there was a hydronephrosis between 1 and 2 cm in diameter; however, calculi were confirmed only in 25 patients. 28 patients required an invasive management with double-J stent insertion under US guidance. The sensitivity and specificity of US in the etiological diagnosis of hydronephrosis during pregnancy was 83 and 91 %, respectively. Conclusion Conservative management with medical therapy and observation should be the first-line treatment approach. In our opinion a rapid ureteral decompression with the insertion of a ureteral double-J stent, under US visualization, is the safest method in the treatment of pregnant women with obstructed renal systems.Keywords Pregnancy Á Hydronephrosis Á Stones Á Ultrasound Á Stent Á Ureteroscopy Riassunto Introduzione Lo scopo del presente studio è stato quello di analizzare il ruolo dell'ecografia nella diagnosi e gestione durante la gravidanza di pazienti affette da idronefrosi sintomatica. Metodi In questo studio abbiamo preso in esame 36 casi di donne in gravidanza complicata dall'insorgenza di un'idronefrosi sintomatica. In tutti i pazienti fu adottato dopo il ricovero in un primo momento un trattamento conservativo (con idratazione e analgesici). I criteri utilizzati per porre indicazione nel posizionamento di uno stent doppio J sotto guida ecografica al posto di un trattamento conservativo sono stati: dolore al fianco persistente senza alcun miglioramento dopo terapia medica, progressivo incremento del quadro idronefrotico (diametro della pelvi renale [2 cm) o comparsa di contrazioni uterine. Risultati L'età media delle pazienti è stata di 25 anni (range 17-35), mentre l'età gestazionale al momento della presentazione del quadro clinico è stata di circa 24 settimane (range 13-37). L'81 % delle pazienti aveva una dilatazione della pelvi renale [2 cm, mentre solo nel 19 % c'è stata un idronefrosi compresa tra 1 e 2 cm di diametro; tuttavia la presenza di calcolosi è stata confermata in sole 25 pazienti. In ventotto pazienti è stata necessaria una gestione invasiva con posizionamento di stent doppio J sotto guida ecografica. La sensibilità e la specificità dell'ecografia nella diagnosi ezio...

show abstract

Section: Discussionmentioning

confidence: 99%

Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy

Dell’Atti

2014

J Ultrasound

View full text Add to dashboard Cite

show abstract

“…Numerous studies on URS in pregnancy prove that it is a safe and effective method of treating urolithiasis in pregnant women in every trimester of pregnancy and the complications incidence is largely dependent on the operator's experience The incidence of complications from URS carried out during pregnancy is similar to that in non-pregnant patients [9] [17] [20]. ESWL and PNL are contraindicated during pregnancy [16]- [18] [20].…”

Section: Discussionmentioning

confidence: 99%

Fatal Urosepsis: A 41 Year-Old Pregnant Woman—Case Report

Gosciniak¹,

Kawecki²,

Miklaszewska³

et al. 2014

OJU

View full text Add to dashboard Cite

Introduction: Urinary tract infections are one of the most frequent infectious complications during pregnancy [1], while acute pyelonephritis is the main non-obstetric reason for hospitalisation [2][3] and septic shock in pregnant women. Objectives and methods: The aim of our study is to analyse the diagnostics and treatment of a 41-year-old pregnant woman with the most severe form of urinary tract infection-urosepsis. Case report: A 41-year old woman in the 12th week of pregnancy hospitalised at Intensive Care Unit (ICU) after urological intervention (JJ stent). On the first day after the intervention, the patient was diagnosed as having urosepsis. Scores: SOFA 14 pts, APACHE II 26 pts, SAPS II SCORE 61 pts. Second day in ICU: spontaneous abortion. Microbiological investigation: Escherichia coli-extended-spectrum beta-lactamase (ESBL+). Conclusions: A pregnant patient with a complicated infection of the urinary system ought to be treated in a multi-profile hospital, offering a possibility to consult doctors of various specialisations (urologist, gynaecologist, anaesthesiologist, nephrologist) as well as full access to a radiology laboratory, which will ensure the choice of appropriate and safe treatment for both the mother and the developing foetus.

show abstract

“…No signs of azotemia were detected. From the literature, 50-80% of stones during the pregnancy period would respond to conservative treatment and about 1/3 of them required surgical intervention (1, 3, 18, 22). …”

Section: Discussionmentioning

confidence: 99%

“…Urinary stone incidence during pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 pregnancies, which is not different from non-pregnant patients (1) and the treatment of symptomatic urolithiasis during the pregnancy period is a challenging issue (1, 2). …”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi

et al. 2013

View full text Add to dashboard Cite

BackgroundUrinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases.ObjectivesThe aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones.Patients and MethodsFrom 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography.ResultsThe mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation.ConclusionsIn conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients’ symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.

show abstract

Urolithiasis in pregnancy

Cited by 31 publications

References 17 publications

Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy

Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy

Fatal Urosepsis: A 41 Year-Old Pregnant Woman—Case Report

The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi

Contact Info

Product

Resources

About