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Kidney stones during pregnancy
Michelle J Semins1, Brian R Matlaga2
1University of Pittsburgh Medical Center, Mercy Hospital, 1350 Locust Street, Suite G100A, Building C, Pittsburgh, PA 15219, USA.
Nature Reviews. Urology
|February 12, 2014
Summary
Kidney stones during pregnancy require special diagnostic and management strategies due to physiological changes. Conservative treatment is often effective, but prompt intervention is crucial for obstructive cases with infection.
Area of Science:
- Nephrology
- Obstetrics
- Urology
Background:
- Kidney stones (nephrolithiasis) affect 10% of the population, with pregnancy presenting unique challenges.
- Physiological and mechanical changes during pregnancy increase kidney stone risk and complicate management.
- Acute nephrolithiasis in pregnancy poses risks to both mother and fetus, necessitating specialized care.
Purpose of the Study:
- To outline diagnostic and management algorithms for kidney stones in pregnant women.
- To highlight the risks associated with acute renal colic during pregnancy.
- To review treatment options and contraindications for kidney stones in pregnancy.
Main Methods:
- Ultrasonography is the primary diagnostic imaging modality.
- Second-line imaging alternatives are considered when necessary.
- Management algorithms prioritize conservative approaches and timely intervention for complications.
Main Results:
- Conservative management (pain control, trial of passage) has a high stone passage rate.
- Obstructive nephrolithiasis with infection requires immediate drainage.
- Ureteroscopy may be an option if conservative treatment fails; temporary drainage is sometimes indicated.
Conclusions:
- Pregnancy-related kidney stones demand tailored diagnostic and management approaches.
- Prompt recognition and intervention are vital for favorable maternal and fetal outcomes.
- Certain procedures like shockwave lithotripsy and percutaneous nephrolithotomy are contraindicated during pregnancy.
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