Nephrolithiasis in Pregnancy

Abstract

Nephrolithiasis is a common condition that practicing urologists will encounter and manage. The pregnant patient presents unique challenges when it comes to the diagnosis and treatment of stones. Altered anatomy and physiology, considerations of the fetus, and various imaging and procedural contraindications make navigating the care of pregnant patients with nephrolithiasis more complex than that of the general population. This review presents an algorithmic approach to the diagnosis and management of nephrolithiasis in the pregnant patient. Certain areas that are highlighted include diagnostic imaging modalities and the pros and cons of each with regard to the pregnant patient. Also discussed in detail are various treatment options, including medical management and available surgical interventions. As renal colic is the most common reason for nonobstetric hospitalization in pregnant women, it is important that they are managed with a multidisciplinary approach. This review contains 2 highly rendered figures, 4 tables, and 26 references Key words: low-dose CT, medical expulsive therapy, nephrolithiasis, obstructive hydronephrosis, percutaneous nephrostomy, physiologic hydronephrosis, pregnancy, renal colic, resistive index, ureteral stent, ureteroscopy