Symptomatic urolithiasis in pregnancy - urological impact and obstetric Outcome

Abstract

Introduction and objectives-Urolithiasis in
pregnancy presents unique management
issues concerning investigation modalities,
treatment of stone and overall concern
over the maternal and fetal well being.
A retrospective audit was performed
in pregnant women presenting with
symptomatic urolithiasis to study the
presentation, management, and the impact
on maternal and fetal wellbeing.
Materials and Method-This was a retrospective
analysis of pregnant women
requiring urological intervention for urolithiasis,
between Jan 2001-March 2012.
Data was collected from the electronic
medical records.Results-There were a
total 18 patients, belonging to the age
group between 18-33 years. 8 of them
were primigravida and 10 were multigravida.
Six of them were in their 1st trimester,
8 in the 2nd and 4 in the 3rd trimester.
Six out of 18 patients presented with
abnormal creatinine (S. creat 0.8mg ).
Seventeen patients presented with colic, 3
presented with LUTS and 7 of them presented
with fever of whom four had a positive
urine culture and one had a positive
urine and blood culture. Median duration of
symptoms at presentation was 120 hours.
In our series 12 out of the 18 patients required
urological intervention, 4 underwent
DJ stenting, 2 URS, 5 PCN and 1 cystolithotomy.
Conclusions-One-third of pregnant
women with symptomatic urolithiasis
had an abnormal serum creatinine. Serum
creatinine more than 1.4mg was associated
with a poor obstetric outcome.
Urological intervention was required in 12
out of 18 patients. It is important to prevent
delay in referral of pregnant women presenting
with symptomatic urolithiasis to an
urologist.