Antenatal ultrasound diagnosis of holoprosencephaly: A case report

Abstract

A distal ureteral calculus may induce premature labor as in our case report. Conservative management of calculi may be the best course in pregnant women without premature labor. However, if premature labor is present, the calculus may be a source of irritation for the gravid uterus. The exact mechanism is unknown. It is widefy accepted that acute pyelonephritis of pregnancy may precipitate premature delivery. Abramowicz and Kass* have convincing evidence showing that bacteriuria increases the risk of prematurity. Bacteriuria may have placed our patient at risk for premature labor. In addition, the obstruction of the kidney by the ureteral calculus may have created a situation ideal for subclinical pyelonephritis. This inflammatory process may have precipitated premature labor. I f a pregnant woman presents with premature labor and a ureteral calculus, a &-adrenergic drug (such as ritodrine) should be started to prevent premature delivery. If this attempt at conservative management proves unsuccessful, stone retrievai with a basket is then indicated if the calculus is below the pelvic brim. The use of spinal anesthesia is advocated. /?,-adrenergic drugs should be continued in the postoperative period until the uterine contractions subside. On the basis of our recent experience, stone retrieval with a basket has a place in the management of pregnant women with premature labor.