URINARY-TRACT STONES IN PREGNANCY

The occurrence of urinary tract calculi in a pregnant woman is one of the most dramatic and problematic set of concurrent conditions encountered by obstetricians, urologists, family physicians, emergency room doctors, pediatricians, radiologists, and anesthesiologists. At the very least an inconvenience, it is also disruptive for the mother and fetus and their support systems. Although the incidence of urinary calculi in pregnancy is low, pain resulting from urinary stones is the most common painful condition requiring hospitalization during pregnancy. Indeed, aside; from first trimester nausea, urinary problems are the most common cause of trouble during pregnancy.(15, 29, 34, 38, 42) Urinary tract calculi can precede the pregnancy, become problematic during the pregnancy, or present in the immediate postpartum period. Evaluation and management decisions depend on the time and type of presentation. In this paper, we discuss the incidence and background; pertinent anatomic and physiologic changes during pregnancy; presentation and initial evaluation of urinary tract calculi, including radiographic studies; and management of the pregnant woman with urinary tract stone disease.