Kidney stones, kidney enlargement, urinary tract infections are urological problems in pregnant women. Assoc. Prof. Dr. Mustafa Kirac explained the treatment for urological problems in pregnancy.

Many changes occur in the body during pregnancy, but the first organ to change is the kidneys. The functioning of the kidney and the filtering of the blood, the blood pressure status of the person is different from the pre-pregnancy period. Therefore, the kidneys should be carefully monitored during pregnancy examinations. In order to prevent possible problems, if pregnancy is planned, urinalysis and blood pressure measurement should be done beforehand and any known kidney failure should be investigated. Kidney disease can also occur during pregnancy in women who have not had any previous kidney problems. The most common kidney ailment during pregnancy is high blood pressure. Blood pressure is usually low in the first three months. In the second 3 months, blood pressure is within normal limits. Another ailment during pregnancy is that hypertension gets worse for different reasons and leads to a disease called preeclampsia.

Kidney Ailments Affect Both Mother And Baby

In case of protein leakage in the urine due to hypertension during pregnancy, serious consequences such as cerebral hemorrhage and even the death of the mother may occur. In addition, if gestational hypertension is not followed and treated regularly, growth retardation or low-weight birth may occur in the baby. Therefore, individuals with high blood pressure, preeclampsia and eclampsia during pregnancy should be followed closely by the relevant physicians.

Kidney Stone Disease In Pregnancy

About one out of every 150 pregnant women have kidney stone problems. Although there is no increase in the frequency of kidney stones detected in pregnant women, existing stones fall into the urinary canal more frequently due to dilatation in the urinary canals during pregnancy, and cause painful pictures. Diagnosing kidney stones in pregnancy is not as easy as in non-pregnant patients. The classic symptoms of kidney stones, such as flank pain, nausea, vomiting and frequent urination, are also seen in pregnant women without kidney stone disease, and depending on the enlarged uterus in pregnant women, stone pain can be felt in different locations such as the waist and groin, and this may make it difficult for the doctor to interpret the pain. Ultrasound, which is a radiation-free method for diagnosis, is also safe for the baby in the mother's womb, and therefore, it can be easily used as the first preferred imaging method in pregnant women with suspected stones.

Most of the stones pass spontaneously after oral medication. For this reason, all pregnant women whose pain and nausea can be controlled with oral medications and whose kidney expansion is not critical are followed up. In patients whose general condition worsens and whose pain and nausea cannot be controlled with oral medications, additional treatment methods should be applied. The main purpose of treatment is to restore urine flow and control pain and nausea without harming the expectant mother and her baby in her womb.

Can Kidney Stone Surgery Be Performed During Pregnancy?

Kidney stones that cannot be treated with medication or monitoring during pregnancy may require surgical intervention. Surgical criteria are the same as for non-pregnant patients, but the presence of the baby requires careful decision-making. If the stone is not excreted, if there is enlargement of the kidney, if there is a serious infection due to the stone, the stone should be intervened. If there is no obstacle to anesthesia in the pregnant, laser stone fragmentation can be done safely. The laser does not harm the kidney. In fact, the safest stone fragmentation method in pregnant women is to use laser. Since stone fragmentation with ultrasound may cause hearing loss in the baby and shock wave stone fragmentation requires the use of radiation, these are not suitable methods for pregnant women. Laser stone fragmentation should be done carefully in pregnant women by experienced urologists.

Recurrent Kidney Infections

Another common problem in pregnant women is recurrent urinary tract infections. Compared with non-pregnant women, there is an increased likelihood of urinary tract infections in pregnant women. Kidney inflammation can both affect the life of pregnant women and negatively affect the health of the baby. In addition, some diseases such as nephritis may be exacerbated by pregnancy. Especially in the sixth month of pregnancy, enlargement of the kidneys may also occur due to the pressure. Diabetic and overweight pregnant women have a high risk of developing infection. Weight and blood glucose should be controlled during pregnancy and 6-8 glasses of water should be drunk daily. If urinary tract infection is not treated appropriately, there is a risk of infection in the mother's blood and delivery of a low birth weight baby.