Ureteral obstruction during pregnancy

We report on a woman with recurrent renal failure due to bilateral ureteral obstruction during the mid trimester of pregnancy. The first pregnancy was terminated due to obstructive renal failure. In the second pregnancy renal function again deteriorated due to bilateral ureteral obstruction. After successful placement of a right ureteral catheter and a left percutaneous nephrostomy, renal function normalized and the gestation was continued through 37 weeks. Recurrent ureteral obstruction during pregnancy was attributed to changes following bilateral ureteral reimplantation. Patients with a history of urologic surgery warrant surveillance for renal failure secondary to mechanical obstruction. Those with a history of proved obstruction during pregnancy might benefit from the prophylactic placement of ureteral catheters and chronic antimicrobial therapy during subsequent gestations.