Kidney Stones in Pregnancy
Incidence and recurrence rates for kidney stones are similar in pregnant and in non-pregnant females, with incidence being 1 in 2000 pregnancies. Nephrolithiasis (kidney stones) and renal colic in pregnancy are more challenging to deal with because CT scans cannot be performed due to radiation safety concerns. Diagnosis is usually based on symptoms and findings of ultrasound of the kidneys and the bladder.
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Multiparous females (women with prior pregnancies) are at higher risk for kidney stones. Patients typically present in the 2nd or 3rd trimester. Pregnancy does not predispose to stones but physiological dilatation of pregnancy leads to higher rate of kidney pain episodes and blood in urine.
Hypercalciuria (high urinary calcium) and hyperuricosuria (high urinary uric acid levels) are common in pregnancy. These can contribute to stone formation.
Diagnosis during pregnancy can be difficult as CT scan cannot be performed due to risks of radiation exposure to the developing fetus. If you have vague abdominal pain, unexplained fever, unresolved bacteriuria, microscopic hematuria consider urological evaluation.
Limited KUB (X Ray) and U/S (Ultrasound) are the radiological modalities of choice in evaluation of renal colic.
[col type=”three-fourth last”]66-85% of stones will pass the calculus spontaneously with conservative management. If needed, stents can be placed cystoscopically with minimal imaging. Dr. Shteynshlyuger often is able to use ultrasound imaging without the need for x-rays. We usually change stents every 4-8 weeks due to increased risk of encrustation/stone formation on the stent.
If symptoms are not tolerable, percutaneous nephrostomy is an option. Ureteroscopy can be safely performed in some pregnant patients during the second trimester.
Dr. Alex Shteynshlyuger is a fellowship trained board certified urologist with expertise in treating pregnant women with kidney stones. If you or someone you know has been diagnosed with renal colic or kidney stones during pregnancy, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice.