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Nephrolithiasis in pregnancy.

P Maikranz, F L Coe, J Parks

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation

|April 1, 1987

Summary

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Nephrolithiasis (kidney stones) in pregnancy is uncommon, despite risk factors. Diagnosis can be challenging, but ultrasound is key, and most stones pass with conservative management.

Area of Science:

Obstetrics and Gynecology
Nephrology
Urology

Background:

Pregnancy involves anatomical and physiological changes increasing kidney stone risk.
Nephrolithiasis during gestation is infrequent, often affecting multiparous women in later pregnancy.
Existing urinary tract infections (UTIs) are more common in pregnant individuals with prior stone disease.

Purpose of the Study:

To review the occurrence, diagnosis, and management of nephrolithiasis in pregnant individuals.
To highlight diagnostic challenges and treatment options for kidney stones during pregnancy.
To discuss the impact of renal colic on pregnancy outcomes and contraindications for medical management.

Main Methods:

Literature review focusing on diagnostic modalities and treatment strategies for nephrolithiasis in pregnancy.

Related Experiment Videos

Analysis of factors influencing stone formation, diagnosis, and management during gestation.

Examination of the physiological changes during pregnancy that may affect stone disease.

Main Results:

Ultrasound is the primary diagnostic tool; limited excretory urograms are reserved for complex cases.
Conservative management facilitates spontaneous stone passage in most instances.
Surgical interventions like cystoscopy can be safely performed when necessary.
Renal colic is a risk factor for premature labor.
Most medications for stone disease are contraindicated during pregnancy.
Increased levels of stone formation inhibitors during pregnancy may mitigate the risk in a hypercalciuric state.

Conclusions:

Nephrolithiasis in pregnancy, though uncommon, requires careful diagnosis and management.
Conservative approaches are preferred, with surgical options available when indicated.
Physiological changes during pregnancy, including increased stone inhibitors, contribute to the low incidence despite risk factors.