Abstract
Renal colic is the most frequent nonobstetric cause for abdominal pain and subsequent hospitalization during pregnancy. The physio-anatomical changes in the urinary tract and the presence of the fetus may complicate the clinical presentation and management of nephrolithiasis. Ultrasound (US) is the primary radiological investigation of choice. Magnetic resonance urography (MRU) and low-dose computed tomography (CT) have to be considered as a second- and third-line test, respectively. If a study that uses ionizing radiation has to be performed, the radiation dose to the fetus should be as low as possible. The initial management of symptomatic ureteric stones is conservative during pregnancy. Intervention will be necessary in patients who do not respond to conservative measures. Therefore, it is crucial to obtain a prompt and accurate diagnosis to optimize the management of these patients. Teaching Points • In pregnancy, renal colic is the most frequent nonobstetric cause for abdominal pain and hospitalization. • Magnetic resonance urography should be considered when ultrasound is nondiagnostic. • Low-dose CT should be considered as a last-line test during pregnancy.
Highlights
Renal colic is the most frequent nonobstetric cause for abdominal pain and subsequent hospitalization during pregnancy [1, 2]
Renal colic has been associated with several pregnancy complications, including preterm labor and delivery, recurrent abortions, hypertensive disorders, gestational diabetes and cesarean deliveries
In a series of pregnant patients with renal colic, 28 % of patients with abdominal pain had an incorrect admitting diagnosis based on clinical evaluation
Summary
Renal colic is the most frequent nonobstetric cause for abdominal pain and subsequent hospitalization during pregnancy [1, 2]. Renal colic has been associated with several pregnancy complications, including preterm labor and delivery, recurrent abortions, hypertensive disorders, gestational diabetes and cesarean deliveries. These potential complications make accurate diagnosis crucial [6, 7]. In a series of pregnant patients with renal colic, 28 % of patients with abdominal pain had an incorrect admitting diagnosis based on clinical evaluation. These diagnoses included appendicitis, diverticulitis and placental abruption [8]. The aim of this review is to explain the use of the different imaging techniques for the diagnosis and management of nephrolithiasis during pregnancy based on a literature review and the authors’ experience
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