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Stone disease in pregnancy: imaging-guided therapy
Gabriele Masselli1, Martina Derme, Maria Giulia Bernieri
1Department Radiology, Università di Roma Sapienza, Viale del Policlinico 155, Rome, 00161, Italy, g.masselli@policlinicoumberto1.it.
Insights Into Imaging
|September 25, 2014
Summary
Renal colic is a common cause of abdominal pain in pregnancy. Prompt diagnosis using ultrasound, magnetic resonance urography, or low-dose CT is crucial for effective management.
Area of Science:
- Obstetrics and Gynecology
- Radiology
- Nephrology
Background:
- Renal colic is the most frequent nonobstetric cause of abdominal pain and hospitalization during pregnancy.
- Physio-anatomical changes in the pregnant urinary tract and the presence of the fetus complicate nephrolithiasis presentation and management.
Purpose of the Study:
- To outline the diagnostic and management strategies for renal colic in pregnant patients.
- To emphasize the importance of prompt and accurate diagnosis for optimizing patient care.
Main Methods:
- Ultrasound (US) is the primary radiological investigation.
- Magnetic resonance urography (MRU) is a second-line test.
- Low-dose computed tomography (CT) is a third-line test, used cautiously due to radiation exposure.
Main Results:
- Conservative management is the initial approach for symptomatic ureteric stones in pregnancy.
- Intervention is reserved for cases unresponsive to conservative measures.
- Minimizing radiation dose to the fetus is paramount if ionizing radiation studies are necessary.
Conclusions:
- Accurate diagnosis is critical for effective management of renal colic during pregnancy.
- MRU should be considered when ultrasound is inconclusive.
- Low-dose CT is a last-line diagnostic option in pregnant patients.
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