Clinical manifestations of pregnancy stones are mainly waist abdominal pain ,
nausea and vomiting , bladder irritation , gross hematuria and fever , and
non-pregnancy symptoms are similar to renal colic treatment and more .
Urolithiasis in pregnancy is rare , the incidence of less than 0.1 %, which,
pregnancy , compared with late merge urinary stones were more common in early
pregnancy .
In view of the X-ray teratogenic and other effects on the fetus , pregnancy
stones disabled patients , including radiation CT. MRI examination of patients
with renal failure and the fetus is safe, especially hydronephrosis caused by
stones , using magnetic resonance imaging of urinary water (MRU) can clearly
show the expansion of the collection system that can clearly show the site of
obstruction . B super high diagnostic accuracy for stones and no damage to the
fetus can be applied repeatedly , as the preferred method. Diagnosis by clinical
manifestations and urinalysis B- urinary stones is not difficult.
Conservative treatment of choice for pregnant women with stones , should be
based on the size of the stones , the site of obstruction , whether there is
infection , with or without clinical symptoms of renal parenchymal damage and to
determine treatment methods. For smaller stones in principle , did not cause
severe renal dysfunction , integrated row of stone treatment, including drinking
water, appropriate increase in activity , infusion diuretic, antispasmodic,
analgesic and anti-infection measures to promote the row of stone .
For patients with stones of pregnancy , maintaining unobstructed urine flow
is the primary goal of therapy. Under local anesthesia by percutaneous renal
biopsy after gastrostomy , or into double J ureteral stent drainage of urine and
other methods that can help stones stones discharged after treatment or to gain
time . The risk of anesthesia and surgery during pregnancy is difficult to
assess , three months before pregnancy (early ) anesthesia can cause an increase
in the chance of birth defects , but it is generally believed that this chance
is very small. Advocate under local anesthesia indwelling ureteral stents , the
proposed replacement once a month to prevent stone formation stent coating on
the stent . Hydronephrosis and infection effusion , before 22 weeks of pregnancy
under local anesthesia and B ultrasound-guided percutaneous nephrostomy is the
best choice, while still draining bacterial culture to guide treatment. Like
with indwelling ureteral stents , percutaneous nephrostomy may also be avoided
during pregnancy greater impact on pregnancy gravel and stone therapy.
About 30% of patients with conservative treatment fails or stone obstruction
with severe infections , acute renal failure and eventually require surgery.
Stones during pregnancy should not be 'ESWL, PNL and URS treatment. But also
reported on the pregnancy stone patients for surgery , including percutaneous
gastrostomy , or into double J ureteral stent , pus nephrectomy , renal pelvis
and ureter lithotomy , PCNL or gravel even after percutaneous nephrolithotomy
surgery . However , if there is extremely difficult to deal with complications
of surgery , generally do not advocate trauma treatment.
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