Watson William J, Brost Brian C
Mayo Clinic College of Medicine, Maternal-Fetal Medicine, Rochester, Minnesota 55905, USA.
Am J Perinatol. 2006 Nov;23(8):463-6. doi: 10.1055/s-2006-954820. Epub 2006 Nov 8.
The purpose of our investigation was to determine the association between flank pain and maternal hydronephrosis during pregnancy. Eighty-one gravidas were evaluated longitudinally with renal ultrasound in each trimester and postpartum. Each was asked about symptoms of flank pain, and then a renal ultrasound was performed. We defined hydronephrosis as a mean pelvic-calyceal measurement of 10 mm or greater. None of the cohort had hydronephrosis in the first trimester, and four had hydronephrosis in the second trimester; almost all maternal hydronephrosis was seen initially in the third trimester. Seventeen (21%) of 81 women had hydronephrosis; 14 on the right side and three bilateral. Nine women reported significant flank pain, and three of these had hydronephrosis. Fourteen women with hydronephrosis reported no flank pain. There was no association observed between flank pain and hydronephrosis ( P = 0.39). All women with hydronephrosis had complete resolution at 6 weeks postpartum. During pregnancy, the association between maternal hydronephrosis and flank pain symptoms is poor. In the clinical evaluation of pregnant women with flank pain, hydronephrosis should not be considered etiologic in the absence of other clinical evidence.
我们此次调查的目的是确定孕期胁腹疼痛与孕妇肾积水之间的关联。对81名孕妇在妊娠各期及产后均进行了肾脏超声纵向评估。每位孕妇均被询问胁腹疼痛症状，随后进行肾脏超声检查。我们将肾积水定义为肾盂肾盏平均测量值达到或超过10毫米。该队列中无一人在孕早期出现肾积水，4人在孕中期出现肾积水；几乎所有孕妇的肾积水最初都出现在孕晚期。81名女性中有17名（21%）出现肾积水；右侧14例，双侧3例。9名女性报告有明显的胁腹疼痛，其中3例有肾积水。14例有肾积水的女性未报告胁腹疼痛。未观察到胁腹疼痛与肾积水之间存在关联（P = 0.39）。所有有肾积水的女性在产后6周时肾积水均完全消退。孕期，孕妇肾积水与胁腹疼痛症状之间的关联较弱。在对有胁腹疼痛的孕妇进行临床评估时，若无其他临床证据，不应将肾积水视为病因。
