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Hydronephrosis of pregnancy
1St. Mary's Medical Center, Evansville, Indiana.
American Family Physician
|June 1, 1991
Summary
Pregnancy commonly causes asymptomatic urinary tract dilation, increasing infection risk. A rare case highlights spontaneous urine extravasation requiring intervention during gestation.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Urology
Background:
- Pregnancy frequently leads to physiological hydronephrosis, affecting up to 90% of women.
- This asymptomatic dilatation of the renal calyces, pelves, and upper ureters occurs with increased renal blood flow and is typically well-tolerated.
- Physiological hydronephrosis may predispose pregnant individuals to urinary tract infections.
Observation:
- Pathologic hydronephrosis during pregnancy can manifest as severe pain, urosepsis, or renal failure.
- A case report details spontaneous urine extravasation in a 19-year-old primigravida at 28 weeks gestation.
- The patient presented with ureteral obstruction necessitating intervention.
Findings:
- The observed case involved a rare complication of pregnancy-related urinary tract changes.
- Spontaneous urine extravasation presented as a critical obstruction requiring immediate management.
- Percutaneous nephrostomy drainage was successfully employed until fetal delivery.
Implications:
- Understanding pregnancy-related urinary tract changes is crucial for early detection of complications.
- Prompt diagnosis and management of pathologic hydronephrosis are essential to prevent adverse maternal and fetal outcomes.
- This case underscores the importance of considering rare urinary complications in pregnant patients presenting with abdominal pain or signs of infection.