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[Physiological hydronephrosis in pregnancy: Occurrence and possible causes. An MRI study]
J Grosjean1, M Cannie2, J-M de Meyer1
1Service d'urologie, CHU Brugmann, Bruxelles, Belgique.
Summary
Pregnancy-related ureter swelling (uretero-hydronephrosis) may be linked to a smaller psoas muscle. This finding suggests a reduced protective effect on the ureter, differentiating physiological from pathological cases.
Area of Science:
- Radiology
- Obstetrics
- Urology
Background:
- Uretero-hydronephrosis in pregnancy is hypothesized to be hormonal or mechanical, with limited investigation beyond ultrasound.
- Magnetic Resonance Imaging (MRI) offers comprehensive visualization of the urinary tract, aiding in identifying mechanical causes.
Purpose of the Study:
- To investigate the potential link between physiological uretero-hydronephrosis in pregnancy and anatomical structures.
- To explore the role of the psoas muscle in the etiology of pregnancy-related uretero-hydronephrosis.
Main Methods:
- Analysis of MRI scans from 100 asymptomatic pregnant women.
- Measurement of psoas muscle dimensions (depth, width, surface area) and assessment of uretero-hydronephrosis location and extent.
Main Results:
- Uretero-hydronephrosis predominantly occurred on the right side (63%) and affected the kidney and/or proximal ureter.
- Proposed etiologies like compression by the uterus or vessels, and protective effects of intestinal structures were largely ruled out.
- A correlation was found between physiological uretero-hydronephrosis and a smaller ipsilateral psoas muscle.
Conclusions:
- A smaller, less developed psoas muscle may offer less protection to the ureter, contributing to physiological uretero-hydronephrosis during pregnancy.
- Left-sided or extensive uretero-hydronephrosis involving the entire ureter in pregnancy may indicate a pathological condition requiring further investigation.
Keywords:
Femmes enceintesHydronephrosisHydronéphroseImagerie par résonance magnétiqueMagnetic resonance imagingMuscle psoasPregnant womenPsoas muscleMore Related Videos
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