Acute symptomatic maternal hydronephrosis in pregnancy: Impact of ureteral catheterization on perinatal outcome

Abstract

Objective: The comparison of perinatal outcome in patients who were treated with and without ureteral catheterization due to acute maternal hydronephrosis. Material and Methods: This retrospective study was conducted at the perinatology clinic of Zekai Tahir Burak Women's health education and research hospital. The patients with acute symptomatic hydronephrosis during pregnancy were included in the study. All of the patients were first treated conservatively. Ureteral catheterization was performed in whom symptoms did not improve despite this treatment. Maternal clinical data and perinatal outcomes were obtained from records of the patients. Results: Seventy-seven patients with symptomatic maternal hydronephrosis were observed (0.27%). A ureteral stent was placed in 9 (group 1) and 68 patients were followed conservatively (group 2). Right kidney was more commonly involved in both groups (p=0.79). Mean serum creatinine in patients with ureteral stents was higher than the patients treated conservatively (p=0.049). Severe pain was observed in 56% of the patients in group1 and was present in 8.8% of patients followed conservatively (p <0.01). Between the two groups, gestational age at delivery, neonatal birth weight and preterm delivery rates did not differ. Low birth weight babies were more frequently born to mothers in group 1 than group 2 (33% and 7.4%, respectively, p=0.02). Gestational ages at disease onset or calyceal diameters were not significantly correlated with gestational age at delivery or neonatal birth weight. Conclusion: The duration or severity of maternal hydronephrosis was not correlated with gestational age at delivery or neonatal birth weight. Perinatal complications are similar in patients with and without ureteral stents except the increased rate of low birth weight infants in patients with ureteral stents.