title: Urolithiasis in pregnancy.
abstract: BACKGROUND
  The aim of this study was to review our experience in the diagnosis and management of urolithiasis in pregnant women, and to discuss safety, appropriate diagnostic tools and treatment modalities with review of literatures.
  
  
  METHODS
  Nine women with pregnancy proved to have urolithiasis were included in this study. The diagnosis was made according to their symptoms and signs, and ultrasonographic findings. Conservative treatment with hydration, analgesics and antibiotics was applied initially, followed by some minimally invasive procedures, including percutaneous nephrostomy (PCN), double J (DBJ) stenting and ureterorenoscopy (URS), if initial treatment failed.
  
  
  RESULTS
  All patients received conservative treatment at first, and 4 patients got well till delivery, another 5 patients needed further minimally invasive procedures; 1 of them received DBJ stenting, another 1 received PCN first and changed to DBJ stenting. The remaining 3 patients were treated by ureterorenoscopy with stone manipulation. All these 5 patiens had full-term delivery without obstetric sequela, except 1 patient who received left salpingoophrectomy due to left ovarian abscess.
  
  
  CONCLUSIONS
  During pregnancy, urolithiasis is a diagnostic and therapeutic challenge. Clinical symptoms and signs are most important in establishing diagnosis, and ultrasound examination adds accuracy. Minimally invasive procedures (such as PCN, DBJ stenting, URS) can facilitate the successful management of patients requiring further intervention due to failure of conservative treatment.
authors.affiliation: Divison of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Ching-Hwa
authors.initials: CH
authors.lastname: Yang
authors.forename: Pei-Hui
authors.initials: PH
authors.lastname: Chan
authors.forename: Siu-Kei
authors.initials: SK
authors.lastname: La
authors.forename: Hsiao-Chun
authors.initials: HC
authors.lastname: Chang
authors.forename: Bin
authors.initials: B
authors.lastname: Chiu
authors.forename: Hsien-Ming
authors.initials: HM
authors.lastname: Lin
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008096:Lithotripsy; D019060:Minimally Invasive Surgical Procedures; D009403:Nephrostomy, Percutaneous; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D015607:Stents; D016216:Ultrasonography, Prenatal; D014545:Urinary Calculi / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy