Hydronephrosis in pregnancy: Critical factors determining urinary catheter use

Pregnancy causes physiological changes, including ureteral compression by the enlarged uterus, leading to hydronephrosis in 90% of cases, though only 3% are symptomatic. This study evaluates outcomes in pregnant women with hydronephrosis managed with or without ureteral stenting to define criteria for intervention.

A retrospective analysis of 92 symptomatic pregnant women with hydronephrosis diagnosed at MP Hospital (2019-2024) was conducted. Patients were categorized into conservative treatment (Group I) and stenting (Group II). Renal dilation, parenchymal thickness, and infection status were assessed.

Patients in Group II also had hydronephrosis at earlier gestational weeks (p < .001), and also had more male fetuses (p = .033), lower parenchymal thickness (p < .001), and higher infection rates (p < .001).

Indicators for stenting in pregnancy-related hydronephrosis include parenchymal thickness ≤20 mm, renal dilation >30 mm, early symptoms, and infections.