Did you know that the most common cause of abdominal pain during pregnancy is urinary stones, also known as Urolithiasis? Though stones during pregnancy are a rare occurrence, a correct and proper diagnosis is necessary to ease the pain and prevent early labor.
Most of the stones are small enough to pass through the urinary tract, but the larger stones require medical intervention and treatment. Let’s look at all the aspects of this disease, especially during pregnancy.
What are Kidney Stones?
Urinary stones are aggregations of chemical substances dissolved in urine. When the concentration level of these substances reaches a particular point, they crystallize and form stones.
What physiological changes lead to kidney stones in pregnant women?
There are a few explicit changes that happen in the lady’s physiology during pregnancy that might influence the urinary parcel prompting expanded possibilities of issues with currently present urinary stone(s) or these progressions could build the opportunity of the development of new kidney stones. The uterus’s size and position can make it harder for urine to come out later in pregnancy.
The ureters get enlarged in pregnancy and may not dispose of pee productively, and this might prompt hydronephrosis. The ureters grow as a result of pregnancy’s increased renal vascular and interstitial volume. The collecting system and ureters also make it harder for them to contract, which makes them dilate and sometimes hurt.
Typical clinical presentation of kidney stones:
It is commonly misdiagnosed as appendicitis, diverticulitis (inflammation or colon wall), or placental abruption. The stones occur in the ureter twice as often as in the kidney and affect both ureters in equal frequency. Here are some common symptoms to look out for:
- Renal colic or severe abdominal or flank pain
- Radiating pain in the groin
- Occurrence of nausea and vomiting
- Dysuria or painful and frequent urination
- Haematuria or blood in the urine
Kidney Stone Disease Treatment & Management
Let’s look at kidney stone treatment and management during pregnancy.
- Conservative management
The patient is advised bed rest, adequate fluid intake, and medications to help manage the disease. Most of the stones (70-80%) pass spontaneously with conservative treatment.
- Stenting – A stent or PCN tube is placed in the ureter. The tube passes the urine lessening the burden on the contraction of the urinary tract. The tube is not removed till the end of pregnancy.
- Extracorporeal Shock Wave Lithotripsy – ESWL uses ultrasonic pulses to fragment renal stones. It is totally contraindicated during pregnancy as it can cause fetal damage and death though it is highly recommended for non-pregnant women.
Prevention of urinary stones
Prevention of urinary stones is the key and is the best cure. Here are the simple prevention tips –
- Drink plenty of fluids including water and keep the body hydrated.
- Don’t hold in the urine, even if it means frequent trips to the washroom or toilet
- Reduce intake of high oxalate foods such as nuts, chocolates, dark green leafy vegetables, and berries
- Discuss prophylactic treatment with a specialist when planning pregnancy, especially if there is history of kidney stones
- Be physically active and exercise as per the doctor’s guidelines