Division of Angiography and Interventional Radiology, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Matern Fetal Neonatal Med. 2022 Mar;35(5):970-974. doi: 10.1080/14767058.2020.1740673. Epub 2020 Mar 19.
Literature on percutaneous nephrostomy (PCN) placement in pregnant patients is limited. The purpose of this case series of 20 pregnant patients was to report short term maternal and fetal outcomes in this population.
A 12-year retrospective study was performed on pregnant patients undergoing PCN. Clinical indications, technical success, maternal outcome, fetal outcome, and complications were obtained from the electronic medical record.
Indications for PCN placement included urolithiasis (40%), congenital ureteral dysfunction in the setting of prior ureteral repair (30%), obstruction associated pain (15%), infection (10%), and ureteral injury in the setting of surgery for ovarian torsion (5%). Catheter insertion was successful in all patients ( = 20), with one major complication (urosepsis). Follow up data was available in 19 patients (95%). Catheters were for a median of 82 days. All patients had clinical and symptomatic improvement. Emergency C-sections were required in two cases. Radiation exposure data were available in 15 of 19 patients and revealed a median fluoroscopy time of 2.8 min, median cumulative dose of 43 mGy, and median dose area product of 635 µGy × m. No adverse fetal outcomes were recorded at time of delivery.
PCN placement has good clinical results as a treatment option for ureteral obstruction in a pregnant cohort.
有关经皮肾造口术 (PCN) 在孕妇中应用的文献有限。本研究通过对 20 例孕妇的病例系列研究，旨在报告该人群中的短期母婴结局。
对接受 PCN 的孕妇进行了一项为期 12 年的回顾性研究。从电子病历中获取临床指征、技术成功率、母体结局、胎儿结局和并发症等信息。
PCN 放置的指征包括尿石症（40%）、既往输尿管修复术后先天性输尿管功能障碍（30%）、与梗阻相关的疼痛（15%）、感染（10%）和卵巢扭转手术相关的输尿管损伤（5%）。所有患者（ = 20）均成功插入导管，仅发生 1 例严重并发症（败血症）。19 例患者中有 19 例（95%）获得了随访数据。导管留置中位数为 82 天。所有患者均有临床和症状改善。有 2 例需紧急剖宫产。15 例中有 15 例患者的放射暴露数据可用，透视时间中位数为 2.8 分钟，累积剂量中位数为 43 mGy，剂量面积乘积中位数为 635 µGy×m。分娩时无胎儿不良结局。
PCN 作为治疗孕妇输尿管梗阻的一种选择，具有良好的临床效果。
