Уретерогидронефроз у беременной: опыт дистанционного бездренажного ведения

Abstract

Introduction. Pregnancy leads to specific physiological and anatomical changes in the woman's body required their differential diagnosis with pathological conditions. Any medical interventions during gestation are associated with risks for both the pregnant woman and the fetus. These factors make it difficult to choose an optimal therapeutic tactics. We have presented results of drainage-free management of a pregnant woman with ureterohydronephrosis using telemedicine technologies. Clinical observation. A 35-year-old woman admitted to the urologist on the 23rd week of her first pregnancy with cystitis. Bacteriuria and rightsided ureterohydronephrosis were diagnosed. There were no indication to ureteral stenting or nephrostomy at that moment. The cystitis was cured. Then this woman was monitored using telemedicine technologies. Discussion. The absence of indications for kidney drainage, the patient's willingness to cooperate and the availability of equipment (a urinary analyzer) made it possible to successfully use drainage-free tactics in this pregnant woman with ureterohydronephrosis. Conclusion. Today the optimal treatment of ureterohydronephrosis in pregnant women is undefined. We must use a ureteral stenting or nephrostomy only if it is strictly indicated. They should include in clinical recommendations the drainage-free management possibility in such patients. The telemedicine technologies contributes to the careful monitoring of the pregnant woman's condition and her greater involvement in the treatment process, as well as increases her compliance with medical interventions.