Clinical characteristics and treatment methods for symptomatic hydronephrosis during pregnancy

  Objective  To summarize the clinical characteristics of hydronephrosis in pregnancy and compare effects of treatment methods.

  Methods  This study included 89 patients with hydronephrosis during pregnancy who were admitted to the Department of Reproductive and Urinary Surgery of Gansu Maternal and Child Health Hospital due to low back pain, fever or abdominal pain, etc. According to different treatment methods, the patients were divided into stent implantation group and conservative treatment group. Age, length of hospital stay, gestation period, complications, degree of hydronephrosis before and after treatment, and white blood cell (WBC) count were compared between the two groups.

  Results  Of 89 patients with hydronephrosis during pregnancy, 97.75% (87/89) patients had mild to moderate hydronephrosis, 69 cases (77.53%) had hydronephrosis on the right side (including bilateral sides), 85 cases (95.51%) were in the middle and late pregnancy, and 25 cases (28.09%) were complicated with urinary calculi. After stenting or conservative treatment, the clinical symptoms of all patients were significantly improved without miscarriage, including 33 cases (37.08%) with complete relief of hydronephrosis, 35 cases (39.33%) with mild hydronephrosis, and 3 cases (3.37%) with moderate hydronephrosis. The mean age of pregnant women in the stent implantation group was (25.60±4.92) years, and that in the conservative treatment group was (28.61±4.54) years, the difference was statistically significant (P<0.05). The median length of hospital stay in the stent implantation group was longer than that in the conservative treatment group, and the difference was statistically significant 7 d (6 to 8 d) versus 5 d (4 to 6 d), P<0.000 1. However, there were no statistically significant differences between the two groups in pregnancy period, complications, degree of hydronhydrone before and after treatment and WBC count (P>0.05).

  Conclusion  Hydronephrosis during pregnancy is common in the second and third trimesters, hydronephrosis mainly occur on the right side of the pregnant, and they usually present urinary stones and other diseases. For symptomatic patients with hydronephrosis in pregnancy, ureteral stent implantation and conservative treatment have similar outcomes. It seems to be more appropriate to choose ureteral stent implantation for the pregnant women with urinary tract diseases.