title: Obstetric complications of ureteroscopy during pregnancy.
abstract: OBJECTIVE
  During pregnancy a ureteral stone and its management may pose risks for the mother and fetus. Definitive ureteroscopic management of an obstructing stone during pregnancy has been increasingly used without a reported increased incidence of urological complications. However, the rate of obstetric complications of ureteroscopy during pregnancy remains undefined.
  
  
  METHODS
  Charts of pregnant women who had undergone ureteroscopy at 5 tertiary centers were reviewed. Patient and procedure characteristics were collected. Records were evaluated for the occurrence of obstetric complications in the postoperative period.
  
  
  RESULTS
  A total of 46 procedures were performed in 45 patients at 5 institutions. There were 2 obstetric complications (4.3%), including 1 preterm labor managed conservatively and 1 preterm labor resulting in preterm delivery. There was no fetal loss. No statistically significant characteristics were identified differentiating those patients having obstetric complications.
  
  
  CONCLUSIONS
  Ureteroscopy performed during pregnancy has been previously reported to be urologically safe and effective for addressing ureteral stones. In our multi-institutional series a 4% rate of obstetric complications was observed. Based on this risk a multidisciplinary approach is prudent for the pregnant patient undergoing ureteroscopy.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. ebj@hitchcock.org
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Johnson
authors.forename: Amy E
authors.initials: AE
authors.lastname: Krambeck
authors.forename: Wesley M
authors.initials: WM
authors.lastname: White
authors.forename: Elias
authors.initials: E
authors.lastname: Hyams
authors.forename: John
authors.initials: J
authors.lastname: Beddies
authors.forename: Tracy
authors.initials: T
authors.lastname: Marien
authors.forename: Ojas
authors.initials: O
authors.lastname: Shah
authors.forename: Brian
authors.initials: B
authors.lastname: Matlaga
authors.forename: Vernon M
authors.initials: VM
authors.lastname: Pais
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000009:adverse effects* / Q000379:methods