Severe early onset preeclampsia secondary to bilateral ureteral obstruction reversed by stenting.
BACKGROUND
Severe early onset preeclampsia might be reversed by correction of an underlying pathophysiologic condition.


METHODS
A 22-year-old nullipara with a history of antivesicoureteral reflux surgery in childhood presented at 23 weeks' gestation with severe headaches, hypertension, proteinuria, edema, and acute renal failure. Severe preeclampsia was diagnosed, and bilateral distal ureteral obstruction was documented by cystoscopy, fluoroscopy, and retrograde pyelography. Bilateral ureteral stent placement completely resolved the preeclampsia and prolonged pregnancy until term.


CONCLUSIONS
Pregnant women with a history of antireflux surgery in childhood might be at risk for acute renal failure and severe preeclampsia caused by bilateral ureteral obstruction. Ureteral stent placement might reverse obstruction, renal failure, and preeclampsia.
Thorp
J A
JA
Obstetrix of Missouri and Kansas, Department of Obstetrics and Gynecology, Saint Luke's Hospital of Kansas City, Missouri, USA. jthorp@saint-lukes.org
Davis
B E
BE
Klingele
C
C
D000328:Adult; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000209:etiology* / Q000628:therapy*; D011247:Pregnancy; D012720:Severity of Illness Index; D015607:Stents; D014517:Ureteral Obstruction / Q000150:complications* / Q000628:therapy*