Urolithiasis disease

It occurs in 0.2-0.8% of pregnant women.

      Clinical picture of urolithiasis

  • renal colic - pains are sharp, paroxysmal. in the lumbar region or along the ureter, when the stone is localized in the lower part of the ureter, pain radiates into the labia majora, the urine follows by drop or does not stand out at all; when the calculus is localized in the upper parts of the urinary tract, pain radiates into the thigh, inguinal region, external genitalia.
  • hematuria,
  • pyuria,
  • withdrawal of stones with urine,

Diagnosis: anamnesis (attacks of renal colic, removal of stones during urination); cystoscopy; chromocystoscopy; ultrasound scanning (X-ray positive, and X-ray negative stones).

The course of pregnancy:

Urolithiasis does not have a significant effect on the development of pregnancy and the fetus, if urolithiasis is not complicated by infection.

Nephropathy of pregnant women, spontaneous abortion, premature birth

Uncomplicated pyelonephritis or nephropathy urolithiasis does not adversely affect the course of pregnancy and fetal development.

Monitoring of pregnant women suffering from urolithiasis is carried out in conditions of a woman's consultation or a polyclinic jointly by an obstetrician and a therapist, a urologist's consultation according to the indications.

The course of labor usually does not represent any peculiarities.

Treatment

An acute period of the disease is anesthetized and a large amount of liquid is injected.

After the departure of the stone, the main method of treatment is drinking drink to maintain intensive urine output (more than 2.5 l / day).

Drug treatment for pregnant women with urolithiasis is aimed at relieving pain and eliminating urinary tract infection:

  • antispasmodics, atropine, novocaine blockade of the round ligament of the uterus
  • catheterization of the ureter with ineffective conservative therapy;
  • antibacterial treatment with a combination of urolithiasis and pyelonephritis.

    Surgery:

  • anuria, caused by obstruction of the ureter with a stone and not amenable to treatment;
  • septic state due to calculous pyelonephritis;
  • pioneophosis;
  • often recurring attacks of renal colic, if there is no tendency to spontaneous separation of stones.

Tactics

If the indications for surgery occur late in pregnancy, the delivery of the woman is premature, and then surgical intervention.

In the earlier stages of pregnancy, if there are indications of patients, it is necessary to operate without taking into account the state of the fetus, since procrastination with interference often threatens the life of a woman.

In the first trimester of pregnancy, you first need to make an artificial abortion, and then transfer the patient to the urological unit for surgery.

The optimal solution is operative treatment of urolithiasis and sanitation of the urinary tract before pregnancy.