Factors Associated With Surgical Intervention in Patients With Renal Colic During Pregnancy [ID: 1366267

Abstract

INTRODUCTION: We studied clinical characteristics of patients whose renal colic and nephrolithiasis are managed surgically in pregnancy compared to patients who were managed expectantly. METHODS: This is a retrospective study of patients presenting with renal colic from June 2013 to May 2022. Clinical characteristics, number of admissions and length of stay, and pregnancy outcomes (preterm labor/preterm delivery or preeclampsia) of patients requiring surgical intervention (SI) were compared to patients that were managed expectantly (EM). Surgical interventions were matched to EM 1:1 based on year of SI. Patients that underwent other nonobstetric surgeries and obstetric surgeries (cerclage) within 30 days of SI were excluded. Institutional review board approval was obtained. RESULTS: One thousand one patients were admitted with renal colic and 40 received SI. Ureteral stents is the commonest procedure (35 patients), followed by percutaneous nephrostomy. Maternal characteristics were similar except for Black race (P=.38). Mean gestational age of presentation is 24.5 weeks in both groups (P>.05). Common indications documented for SI are intractable pain (80%) and obstructing stone with sepsis (40%). The mean pain score was 5.2 in SI versus 1.6 in EM (P=.00). Fever was seen in 15.5% of SI versus 2.5% in EM (P=.04). Computed tomography scan performed in 22.5% of SI versus 2.5% in EM. Number of admissions were 1.75 versus 1.08 in EM (P=.03). Length of stay was 5.34 versus 1.38 days in EM (P=.00). Pregnancy outcomes were similar (P>.05). CONCLUSION: Black race, pain score greater than 5, and fever are more likely to have SI. Surgical intervention can be safely performed in pregnancy without increase in adverse outcomes.