Hydronephrosis, a condition characterised by the swelling of the kidneys due to the build-up of urine, poses unique challenges when it occurs during pregnancy. As expectant mothers undergo numerous physiological changes, including increased blood volume and pressure on the urinary system, the risk of developing hydronephrosis becomes more pronounced. This article aims to shed light on the causes, symptoms, and management of hydronephrosis in pregnancy, providing valuable insights for healthcare professionals and expecting mothers alike.
What Causes Hydronephrosis in Pregnancy?
Physiological – During pregnancy, hormonal changes and the growing uterus can lead to compression of the ureters, the tubes that carry urine from the kidneys to the bladder. This compression can obstruct the flow of urine, causing it to accumulate and dilate the renal pelvis and calyces, resulting in hydronephrosis. Such hydronephrosis forms in 2nd trimester more commonly on the right side kidney of the mother.
Mechanical – obstruction can be due to stone in ureter or ureteric obstruction due to stricture.
Additionally, the increased blood volume and pressure on the kidneys can further exacerbate this condition.
What Are the Symptoms of Hydronephrosis in Pregnancy?
Physiological hydronephrosis in pregnancy is usually asymptomatic but there can be increased incidences of associated ascending urinary tract infection (pyelonephritis) which can result in fever, dysuria and flank pain.
Obstructive hydronephrosis due to ureteric obstruction or due to stone results in severe flank pain, dysuria, hematuria etc.
How Is Hydronephrosis Diagnosed during Pregnancy?
When hydronephrosis is suspected during pregnancy, healthcare providers may utilize various diagnostic tests to confirm the diagnosis and assess its severity. These may include:
- Ultrasound: This non-invasive imaging technique allows for visualization of the kidneys and urinary tract to identify any signs of obstruction or dilation.
- Magnetic resonance imaging (MRI) or computed tomography (CT) scan: In certain cases, more detailed imaging may be necessary to evaluate the extent of the hydronephrosis and identify any underlying causes.
- Urinalysis: Testing the urine for the presence of blood, bacteria, or other abnormalities can help rule out urinary tract infections or other contributing factors.
What is the Treatment for Hydronephrosis during Pregnancy?
Physiological hydronephrosis – is asymptomatic in 90% cases which does not need any treatment, however ascending urinary tract infection or pyelonephritis may require antibiotic therapy and other symptomatic measures like pain management and maintenance of hydration.
Obstructive hydronephrosis due to calculi (Chance of stone formation during pregnancy is less than 1%)- Mainly conservative management (if the stone is small in size) and no other complication like fever/ infected hydronephrosis or pyelonephritis.
Failed medical management of small stone or increasing hydronephrosis due to ureteric stone or infected hydronephrosis may require cystoscopy and ultrasound guided stent insertion or PCN in kidney to relieve symptoms and protect kidney.
Conclusion
Hydronephrosis in pregnancy presents unique challenges that require careful monitoring and management to ensure optimal outcomes for both mother and baby. By understanding the causes, symptoms, and management strategies associated with this condition, healthcare providers can provide timely interventions and support to expectant mothers, minimizing potential complications and promoting a healthy pregnancy.
Best Hospital for Treating Urological Problems in Pregnancy – Institute of Urology, C Scheme, Jaipur
At the Institute of Urology, our commitment to advancing urological care extends to every stage of life, including pregnancy and postnatal care. With our state-of-the-art facilities and cutting-edge technology, we stand as a beacon of excellence in the treatment of urological conditions during pregnancy, as well as antenatal and postnatal care. Our multidisciplinary team of urologists and specialized nurses collaborates seamlessly to provide comprehensive and personalized care to expectant mothers and new mothers alike.
From the management of urinary tract infections and kidney stones during pregnancy to addressing pelvic floor disorders and urinary incontinence postpartum, we leverage the latest advancements in urological medicine to ensure the safety and well-being of both mother and baby. With our unwavering dedication to innovation, compassion, and excellence, the Institute of Urology remains the trusted choice for women seeking advanced urological care throughout their pregnancy journey and beyond.
You can also avail the facility of online consultation before visiting us in person in order to discuss your problems with our Senior Urologist. We can be reached at the following numbers:
Dr. M. Roychowdhury – 9929513468
/ 9829013468
Dr. Rajan Bansal – 8601539297
References:
- Rasmussen PE, Nielsen FR. Hydronephrosis during pregnancy: a literature survey. Eur J Obstet Gynecol Reprod Biol. 1988;27(3):249-259.
- Hilton P. Ureteric and renal pelvic dilatation in pregnancy. BJOG. 1980;87(8):663-671.
- Smith C, Smith W. Hydronephrosis in pregnancy: a literature review. Arch Gynecol Obstet. 2016;294(2):229-236.
- Rosenberg ER, Zimmern PE. Pregnancy and hydronephrosis: physiology and management. Curr Urol Rep. 2002;3(2):109-117.
- Wahbi A, Batool S, Memon WA, Haleem A, Gul T, Zehra N. Hydronephrosis in pregnancy: a review of literature. Int J Womens Health. 2016;8:773-778.
