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Ureteric obstruction by the gravid uterus.
M P Carey1, B U Ihle, C S Woodward
1Mercy Maternity Hospital, Melbourne.
Summary
Gravid uterus can cause ureteric obstruction in pregnant individuals. This rare condition, seen in 6 cases over 17 years, resolved after delivery, highlighting pregnancy-related urinary tract complications.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Urology
Background:
- Ureteric obstruction during pregnancy is uncommon.
- The gravid uterus can exert pressure on the ureters, leading to obstruction.
Observation:
- This study identified 6 cases of ureteric obstruction attributed to the gravid uterus over 17 years at a single institution.
- Radiographic evidence in 3 cases confirmed obstruction at the pelvic brim.
- Three cases with polyhydramnios developed bilateral ureteric obstruction and acute renal failure.
Findings:
- Obstruction resolved rapidly postpartum, confirming the gravid uterus as the cause.
- Cases presented with varying severity, including unilateral obstruction with pyelonephritis.
- Interventions ranged from ureteric catheterization and stenting to percutaneous nephrostomy.
Implications:
- Highlights the importance of considering gravid uterus as a cause of ureteric obstruction in pregnant patients.
- Suggests prompt diagnosis and management are crucial for preventing renal complications.
- Emphasizes the need for awareness among obstetricians and urologists regarding this rare but serious condition.