Abstract
Background
Urolithiasis is the most common cause for non-obstetrical abdominal pain and accounts for 1.7 admission per 1000 deliveries. Reported incidence range from 1:125 to 1:2000, most commonly in the second and third trimester. The pregnant patient offers numerous challenges when presenting acutely with an obstructed urinary system as physiological and anatomical changes serve as a catalyst to provoke pathological outcomes.
Main Body
Diagnosis and management of urolithiasis is particularly challenging with respect to imaging, with the use of computed tomography restricted. Prompt diagnosis is needed as pregnancies with stones is associated with an increased risk of fulminating sepsis and preterm delivery. Most pregnant patients can be managed conservatively but 1 in 4 patients require operative intervention. Decisions pertaining to operative intervention are complex and can range from nephrostomy insertion to empirical stent placement or ureteroscopy. A multidisciplinary is required in decision making to optimise patient’s care.
Conclusion
The diagnosis and management of urolithiasis in pregnancy is complex. Herein, we review the role of different diagnostic tests for acutely obstructed kidneys in pregnancy, the treatment options and explore their safety, advantages and disadvantages.
Urolithiasis is the most common cause for non-obstetrical abdominal pain and accounts for 1.7 admission per 1000 deliveries. Reported incidence range from 1:125 to 1:2000, most commonly in the second and third trimester. The pregnant patient offers numerous challenges when presenting acutely with an obstructed urinary system as physiological and anatomical changes serve as a catalyst to provoke pathological outcomes.
Main Body
Diagnosis and management of urolithiasis is particularly challenging with respect to imaging, with the use of computed tomography restricted. Prompt diagnosis is needed as pregnancies with stones is associated with an increased risk of fulminating sepsis and preterm delivery. Most pregnant patients can be managed conservatively but 1 in 4 patients require operative intervention. Decisions pertaining to operative intervention are complex and can range from nephrostomy insertion to empirical stent placement or ureteroscopy. A multidisciplinary is required in decision making to optimise patient’s care.
Conclusion
The diagnosis and management of urolithiasis in pregnancy is complex. Herein, we review the role of different diagnostic tests for acutely obstructed kidneys in pregnancy, the treatment options and explore their safety, advantages and disadvantages.
| Original language | English |
|---|---|
| Journal | Current Urology |
| Publication status | Accepted/In press - 4 Jan 2023 |