Placement of ureteral stents in pregnancy using ultrasound guidance

Urolithiasis is one of the most common causes of pain in pregnancy. Renal calculi can create a diagnostic and therapeutic challenge; left untreated, they can adversely affect maternal and fetal outcome. Although most cases of obstructive uropathy can be managed conservatively, some require relief of obstruction, usually by placement of a ureteral stent. We describe the use of ultrasound to identify an obstructed collecting system and provide guidance for placement of a double-pigtail ureteral stent in two pregnant patients. The technique used to manipulate the guide wire and stent into the renal pelvis under real-time ultrasound monitoring is discussed.