Abstract No. 575 A retrospective analysis of a single-center experience with percutaneous nephrostomy during pregnancy

Abstract

Percutaneous nephrostomy has been used to treat symptomatic renal obstruction. Although there have been small published series describing safety and efficacy, this study assesses our experience over 12 years placing PCNs in pregnant women in a tertiary care academic medical center. In this IRB approved study, all patients undergoing percutaneous nephrostomy (PCN) from 7/1/2005 through 7/1/2017 were identified through a Hi-IQ database search. Only patients who were pregnant at the time of PCN placement were included. A retrospective review was performed to include demographics, gestational age, clinical indications, technical success, maternal outcome, fetal outcome, and complications. Twenty-one subjects were included with a median age of 28 (range, 19-38). The median gestational age at the time of intervention was 26 weeks (range, 8-38). Of the 21 patients undergoing percutaneous nephrostomy 7 (33%) had hydronephrosis secondary to calculi, 7 (33%) due to congenital ureteral dysfunction and childhood ureteral re-implantation, 2 (10%) had failed internal ureteral stenting, 2 (10%) had urosepsis. There was one case each of the following: gravid uterus with ureteral compression, ureteral trauma in the setting of surgery for presumed ovarian torsion, and hydronephrosis with associated flank pain. Eleven (52%) patients had moderate hydronephrosis, 8 (38%) had severe hydronephrosis, and 2 (10%) had mild hydronephrosis. Technical success was 100% (21/21). 91.5% of pregnancies continued to term. One fetus in the cohort was delivered prematurely at 31 weeks (4.7% preterm delivery). One pregnancy was terminated as it was undesired. There were no major or minor complications related to the procedure. Percutaneous nephrostomy during pregnancy has excellent technical success and good maternal and fetal outcomes.