Maternal hydronephrosis in pregnancy: Poor correlation with clinical symptoms

Abstract

ObjectiveThe objective of this study was to investigate the incidence, timing, and severity of maternal hydronephrosis during pregnancy, and to correlate these findings with maternal symptoms of flank pain.Study designEighty one subjects were prospectively studied longitudinally during pregnancy. We included consecutive patients with a singleton pregnancy. Gravidas with chronic medical illness, recurrent UTI or pyelonephritis, or history of renal stones were excluded. Real time ultrasound of the maternal kidneys was done serially, in the first, second and third trimesters, as well as postpartum. Each subject was questioned about presence and severity of flank pain prior to the ultrasound. Scans were perfomed by a registered diagnostic medical sonographer, and all images were reviewed by one of the authors. All patients had 4 ultrasound studies performed.ResultsSeventeen of 81 patients (21%) were observed to have some degree of hydronephrosis, 14 on the right side and 3 bilateral. No cases of hydronephrosis were observed during the first trimester. Four of 81 had hydronephrosis initially noted during the second trimester; most cases were observed only during the third trimester. Nine patients reported significant flank pain; three of these had hydronephrosis. There was no observed correlation between flank pain and the development of hydronephrosis. Chi square = .282, P = .60; RR = 1.88 (0.54-6.15). There was no correlation between maternal symptoms and severity of hydronephrosis. Two patients developed severe hydronephrosis, with a mean renal pelvis diameter >7 cm, and both had no flank pain. At post partum sonography, all cases of hydronephrosis had resolved.ConclusionTabled 1Correlation of hydronephrosis with flank pain: Clinical resultsHydronephrosis +Hydronephrosis −Flank pain36No flank pain1458 Open table in a new tab ObjectiveThe objective of this study was to investigate the incidence, timing, and severity of maternal hydronephrosis during pregnancy, and to correlate these findings with maternal symptoms of flank pain. The objective of this study was to investigate the incidence, timing, and severity of maternal hydronephrosis during pregnancy, and to correlate these findings with maternal symptoms of flank pain. Study designEighty one subjects were prospectively studied longitudinally during pregnancy. We included consecutive patients with a singleton pregnancy. Gravidas with chronic medical illness, recurrent UTI or pyelonephritis, or history of renal stones were excluded. Real time ultrasound of the maternal kidneys was done serially, in the first, second and third trimesters, as well as postpartum. Each subject was questioned about presence and severity of flank pain prior to the ultrasound. Scans were perfomed by a registered diagnostic medical sonographer, and all images were reviewed by one of the authors. All patients had 4 ultrasound studies performed. Eighty one subjects were prospectively studied longitudinally during pregnancy. We included consecutive patients with a singleton pregnancy. Gravidas with chronic medical illness, recurrent UTI or pyelonephritis, or history of renal stones were excluded. Real time ultrasound of the maternal kidneys was done serially, in the first, second and third trimesters, as well as postpartum. Each subject was questioned about presence and severity of flank pain prior to the ultrasound. Scans were perfomed by a registered diagnostic medical sonographer, and all images were reviewed by one of the authors. All patients had 4 ultrasound studies performed. ResultsSeventeen of 81 patients (21%) were observed to have some degree of hydronephrosis, 14 on the right side and 3 bilateral. No cases of hydronephrosis were observed during the first trimester. Four of 81 had hydronephrosis initially noted during the second trimester; most cases were observed only during the third trimester. Nine patients reported significant flank pain; three of these had hydronephrosis. There was no observed correlation between flank pain and the development of hydronephrosis. Chi square = .282, P = .60; RR = 1.88 (0.54-6.15). There was no correlation between maternal symptoms and severity of hydronephrosis. Two patients developed severe hydronephrosis, with a mean renal pelvis diameter >7 cm, and both had no flank pain. At post partum sonography, all cases of hydronephrosis had resolved. Seventeen of 81 patients (21%) were observed to have some degree of hydronephrosis, 14 on the right side and 3 bilateral. No cases of hydronephrosis were observed during the first trimester. Four of 81 had hydronephrosis initially noted during the second trimester; most cases were observed only during the third trimester. Nine patients reported significant flank pain; three of these had hydronephrosis. There was no observed correlation between flank pain and the development of hydronephrosis. Chi square = .282, P = .60; RR = 1.88 (0.54-6.15). There was no correlation between maternal symptoms and severity of hydronephrosis. Two patients developed severe hydronephrosis, with a mean renal pelvis diameter >7 cm, and both had no flank pain. At post partum sonography, all cases of hydronephrosis had resolved. ConclusionTabled 1Correlation of hydronephrosis with flank pain: Clinical resultsHydronephrosis +Hydronephrosis −Flank pain36No flank pain1458 Open table in a new tab