Kidney Stones During Pregnancy
Kidney stones during pregnancy are not uncommon. Although, the incidence of kidney stones is similar in pregnant and non-pregnant women, only the likely hood of a woman falling prey to kidney stones increases during pregnancy. The concern is that symptoms may either be masked by the throes of pregnancy or may be diagnosed because of the discomfort caused in this sensitive situation.
Testing a pregnant woman for kidney stones is another concern as anesthesia, radiation, and treatment may have adverse effects. Of various options available, a renal ultrasound is the first test of choice for urologists. However, doctors lament that ultrasound is not very reliable as far as diagnosing kidney stones is concerned and CAT can not be utilized because of the use of radiations involved. Symptoms in themselves can never be taken as a touchstone for the existence of kidney stones. Any intravenous testing is put off until the case is very complex and calls for such diagnosis.
Kidney stones in a pregnant woman do not directly threaten the fetus in the womb. They however make it a difficult time for the new mother. There’s a great likelihood of the stone passing out with the urine. They do so in 60%-80% of the pregnant women. In a situation contrary to that, a kidney stone may initiate premature labor, produce intractable pain in the patient, cause urosepsis in the setting of a urinary tract infection, or interfere with the progression of normal labor. It is important that the location of the stones be immediately pointed out. A stone in the kidneys does not pose as great a problem as the complications that may arise if the stone is lodged in the urinary tract.
Kidney stones besides being painful may lead to preterm birth and kidney infection. If there is a stone in a kidney, it may block the flow of urine. This may have some serious repercussions as far as pregnant patients re concerned. It may lead to high blood pressure which in turn can be a risk for the healthy growth of the fetus which may also be born pre-maturely.
Lithotripsy as a treatment for pregnant kidney stone patients is completely out of the question. This is because shock wave therapy requires the patient to be under anesthesia which cannot be administered to a pregnant patient without severe repercussions. Besides, the shock waves may have an adverse effect on the young unborn baby. Thus, in preference to lithotripsy, women may be given a urethral stent. A stent is a small tube that is inserted through the bladder to reach the kidney. It works to facilitate the outflow of urine thereby providing relief from the blockage as well as the pain associated with it. This stent however, gathers a lot of calcium and needs to be replaced every six to eight weeks. A urethral stent is ideal for a woman who is at the end of her pregnancy term as she would not require any replacements.
Another option is a nephroscope tube which is inserted through a tiny incision on the back. This tube contains a bag at the end. This method though cumbersome is the least non-invasive and is ideal if the stones need to be monitored for a considerable amount of time.
All said and done, women should not be treated for kidney stones during their pregnancy. Susceptible women and those with a history of kidney stones must get a thorough check up done before trying to get pregnant.
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