[Pregnancy and lithiasis of the upper urinary tract. Clinical aspects and therapeutic management].
Upper urinary tract calculi can be difficult to diagnose and to treat. One has to be aware that there is a risk for the mother which is often not recognized in the long term. The authors describe 17 cases of pregnant women aged between 20 and 33 who were treated for calculi in the Urological Service in Poitiers. They were diagnosed at different stages of pregnancy and a few had a previous urological history. The women presented in different ways, several of them with urinary colic and 10 with urinary colic and fever. Urinary tract infection and septicaemia also occurred. Six patients passed the stones spontaneously. The rest had to be treated by some form of operation, either during the pregnancy or afterwards, including one case of a patient who had to have her kidney and ureter removed and another who had to have a kidney removed. One patient had to have an emergency caesarean section for fetal distress although she had had stone removed at the 20th week of pregnancy. It is not possible to know from this series the incidence of stones in the tract. Various theories of the formation of the stones, including the anatomical changes that occur in the urinary tract in pregnancy, are suggested and these include the hormonal theory of dilatation of the ureters as well as the mechanical theory of changes in the course of the ureters. There are also likely to be changes in the phosphocalcium metabolism. Pain in the lumbar and lower abdominal region is the most frequent symptom occurring in 90-100% of cases and urinary tract infection is common.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D002118:Calcium / Q000378:metabolism; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000628:therapy; D014545:Urinary Calculi / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000628:therapy
D002118:Calcium
Grossesse et lithiase du haut appareil urinaire. Aspects cliniques et conduite thérapeutique.