Urolithiasis and pregnancy. Presentation of results and management norm at the National Institute of Perinatology

• Published in: Ginecologia y obstetricia de Mexico Vol. 72; pp. 515 - 524
• Main Authors: Romero Nava, Luis Eduardo, Velázquez Sánchez, María del Pilar, Kunhardt Rasch, Jorge Ralph
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01-10-2004
• Subjects: Adult; Cohort Studies; Decision Trees; Female; Humans; Incidence; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy Complications - therapy; Prevalence; Urinary Calculi - complications; Urinary Calculi - diagnosis; Urinary Calculi - epidemiology; Urinary Calculi - therapy
• ISSN: 0300-9041

Urolithiasis associated to pregnancy has an incidence of 1:1,500. It is more frequent in multiparity patients and is a risk factor for preterm labor in more than 40%.
To know the incidence of urolithiasis associated to pregnancy at the National Institute of Perinatology; to determine the prevalence of: symptoms and signs, hydronephrosis, urinary tract infections, uropathogens, use of catheters and perinatals results.
A cohort study was made from January 1998 to October 2003, to identify pregnant patients with urolithiasis. The clinical files were reviewed; Fisher's exact test was used for statistical analysis.
Twenty-one patients were diagnosed with urolithiasis; 71% had lumbar pain; 57.1% hematuria; 47.6% bilateral urolithiasis; and 33% bilateral hydronephrosis. All the patients who had lumbar pain, hematuria or were catheterized developed urinary tract infection, even with antibiotics prophylaxis. The 52.4% had at least one urinary tract infection episode. The average gestational age at birth was 38.5 weeks (+/- 5.6 weeks). The 84.22% were preterm births.
Our incidence is similar to the one reported in the literature. The 71.26% has at least one of the symptoms from the classic triad of urolithiasis. The prevalence of urinary tract infection in these patients is very high therefore; antibiotics prophylaxis and urine cultures are required. A lower prevalence of preterm births was obtained. A flow chart for diagnosis and follow-up was presented in order to decrease and to face the possible complications of this pathologic entity.