The efficacy and safety of ultrasound guided percutaneous drainage of pyonephrosis during pregnancy

Abstract

Background: Upper urinary tract obstruction during pregnancy carries high risk of maternal and fetal complications. The most serious complications are infection and urosepsis, abortion or premature labor, and intrauterine fetal death. Studies that involved non-infected upper urinary tract obstruction during pregnancy recommend the use of either a retrograde passage of JJ stent or a guided percutaneous nephrostomy. The aim of this study was to assess the efficacy and safety of percutaneous nephrostomy in treatment of septic obstruction of the upper urinary tract during pregnancy. Methods: The present study involved 21 pregnant woman with unilateral obstructive uropathy, 9 of theme treated by inserting an ipsilateral double J stent, whereas 12 patients treated by ultrasound-guided percutaneous nephrostomy. Results: All patients treated by nephrostomy got clinical improvement within the first 48 postoperative hours and all of them completed their pregnancy and delivered full term baby by normal vaginal delivery. Conclusion: We conclude that ultrasound-guided percutaneous nephrostomy catheter drainage of infected obstructed upper urinary tract during pregnancy is a safe, effective and life-saving procedure and considered as first line of drainage in such patients.