MANAGEMENT PROTOCOL OF ACUTE HYDRONEPHROSIS IN PREGNANCY

Authors

  • M IQBAL Civil dispensary Gulbhar- 2, Pakistan
  • M AKHTAR Department of Emergency Medicine, POF Hospital, Wah Cantt, Rawalpindi, Pakistan
  • A ALI Riphah International University Islamabad, Pakistan
  • MT JADOON Riphah International University Islamabad, Pakistan
  • I LODHI University of Veterinary and Animal Sciences, Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.686

Keywords:

Acute Hydronephrosis, Pregnancy, Management Protocol, Gestational Age, Ureteral Calculi, Ureteral Stenting

Abstract

Acute hydronephrosis during pregnancy poses significant management challenges due to the physiological changes and risks associated with the intervention. Addressing this condition effectively requires a multidisciplinary approach and a deeper understanding of its clinical management. Objective: This study aims to evaluate a comprehensive care strategy for managing acute symptomatic hydronephrosis in pregnant women by analysing various treatment measures and their outcomes. Methods: A prospective cohort study was conducted at the tertiary care hospital from November 1, 2022, to October 31, 2023. The study enrolled 125 pregnant patients experiencing acute hydronephrosis at any stage of pregnancy. Patients with pre-existing renal disorders, incomplete medical records, or who were untraceable were excluded. Data were collected through extensive electronic and paper medical records searches, focusing on demographic features, clinical presentation, and therapeutic outcomes. The severity of hydronephrosis was classified as mild, moderate, or severe, and the impact of interventions like percutaneous nephrostomy was evaluated. Results: The average age of participants was 28.5 years, with the majority (36%) aged between 25 and 29 and 56% being multigravida. The average gestational age at presentation was 28.2 weeks, and 72% reported flank pain. Hydronephrosis was mild at 30.4%, moderate at 50.4%, and severe at 19.2%. The percutaneous nephrostomy caused complications in 10% of mothers and 5% of fetuses, while postoperative complications were more pronounced, affecting 25% of mothers and 20% of fetuses. Conclusion: The study provides valuable insights into the effective management of acute hydronephrosis during pregnancy, highlighting the demographic characteristics, clinical manifestations, and outcomes of different treatment modalities. The findings suggest that while percutaneous nephrostomy is a relatively safe procedure, it still poses significant risks, necessitating careful consideration and a tailored approach for each patient.

Downloads

Download data is not yet available.

References

Beloborodov V, Vorobev V, Golub I, Frolov A, Kelchevskaya E, Tsoktoev D, et al. A multidisciplinary approach to urinary system iatrogenic injuries. Central European Journal of Urology. 2020;73(4):534.

Melady D, Perry A. Ten best practices for the older patient in the emergency department. Clinics in geriatric medicine. 2018;34(3):313-26.

Bauer I, Hartkopf J, Kullmann S, Schleger F, Hallschmid M, Pauluschke-Fröhlich J, et al. Spotlight on the fetus: How physical activity during pregnancy influences fetal health: A narrative review. BMJ Open Sport—Exercise Medicine. 2020;6(1).

Stapleton LRT, Schetter CD, Westling E, Rini C, Glynn LM, Hobel CJ, et al. Perceived partner support in pregnancy predicts lower maternal and infant distress. Journal of family psychology. 2012;26(3):453.

Moon-Grady AJ, Baschat A, Cass D, Choolani M, Copel JA, Crombleholme TM, et al. Fetal treatment 2017: the evolution of fetal therapy centres joint opinion from the International Fetal Medicine and Surgical Society (IFMSS) and the North American Fetal Therapy Network (NAFTA). Fetal diagnosis and therapy. 2017;42(4):241-8.

Melaku L. Physiological Changes in the Pregnancy and Anesthetic Implication during Labor, Delivery, and Postpartum. The Open Anesthesia Journal. 2022;16(1).

Powers SA, Burleson LK, Hannan JL. Managing female pelvic floor disorders: a medical device review and appraisal. Interface Focus. 2019;9(4):20190014.

Mileto A, Itani M, Katz DS, Siebert JR, Dighe MK, Dubinsky TJ, et al. Fetal urinary tract anomalies: review of pathophysiology, imaging, and management. American Journal of Roentgenology. 2018;210(5):1010-21.

Rasouly HM, Lu W. Lower urinary tract development and disease. Wiley Interdisciplinary Reviews: Systems Biology and Medicine. 2013;5(3):307-42.

Geerlings SE. Clinical presentations and epidemiology of urinary tract infections. Microbiology spectrum. 2016;4(5):4.5. 03.

Milutinovic J, Fialkow PJ, Agodoa LY, Phillips LA, Rudd TG, Bryant JI. Autosomal dominant polycystic kidney disease: Symptoms and clinical findings. QJM: An International Journal of Medicine. 1984;53(4):511-22.

Chand R, Shah A, Pant D, Paudel S. Common site of urinary calculi in kidney, ureter and bladder region. Nepal Med Coll J. 2013;15(1):5-7.

Berghmans, Hendriks, Bie D. Conservative treatment of stress urinary incontinence in women: a systematic review of randomised clinical trials. British journal of urology. 1998;82(2):181-91.

Azwadi IZK, Norhayati MN, Abdullah MS. Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis. Scientific reports. 2021;11.

Beta J, Khan N, Khalil A, Fiolna M, Ramadan G, Akolekar R. Maternal and neonatal complications of fetal macrosomia: systematic review and meta‐analysis. Ultrasound in Obstetrics & Gynecology. 2019;54(3):308-18.

Golan A, Lin G, Evron S, Arieli S, Niv D, David MP. Oligohydramnios: maternal complications and fetal outcome in 145 cases. Gynecologic and obstetric investigation. 1994;37(2):91-5

Downloads

Published

2024-08-18

How to Cite

IQBAL, M., AKHTAR, M., ALI, A., JADOON, M., & LODHI, I. (2024). MANAGEMENT PROTOCOL OF ACUTE HYDRONEPHROSIS IN PREGNANCY. Biological and Clinical Sciences Research Journal, 2024(1), 686. https://doi.org/10.54112/bcsrj.v2024i1.686

Most read articles by the same author(s)

1 2 3 4 5 > >>