Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul.
Department of Obstetrics and Gynecology, School of Medicine, Istanbul Medipol University, Istanbul.
Arch Ital Urol Androl. 2021 Mar 18;93(1):35-41. doi: 10.4081/aiua.2021.1.35.
The aim of this study is to determine the proportion of maternal hydronephrosis and symptomatic cases requiring treatment in pregnant women without ureteral stones and the characteristics of these cases.
Between February 2018 and April 2019, all pregnant women followed for pregnancy in obstetrics and outpatient policlinic were evaluated prospectively. Maternal hydronephrosis rate, degree of hydronephrosis and side, symptomatic hydronephrosis rate, maximum renal anteroposterior diameter of renal pelvis and visual analogue scale were detected. Symptomatic patients were treated conservatively or surgically. Findings in both treatment groups were analyzed by t-test or Chi-squared test. Pearson or Spermean's tests were used for correlation analyzes.
A total of 1026 pregnant women aged 18-45 (27.7 ± 5.2 years) were followed prospectively. The rate of maternal hydronephrosis was 28.7% and the rate of symptomatic hydronephrosis was 4.7%. Of the patients with symptomatic hydronephrosis, 73.4% (3.5% of total) were treated conservatively and 26.5% (1.3% of total) were treated surgically. There was a positive correlation between hydronephrosis and gestational week (p < 0.001), visual analogue scale (p < 0.001) and hematuria (p < 0.05). There was a negative correlation between hydronephrosis and maternal age (p < 0.05) and number of pregnancies (p < 0,001). The anteroposterior diameter of renal pelvis (p < 0.001), visual analogue scale (p < 0.05) and fetal body weight values (p < 0.05) on the right side were higher in the surgical treatment group than the conservative group.
The majority of cases with maternal hydronephrosis in pregnant women without ureteral stones are asymptomatic. Most symptomatic cases can also be treated conservatively. In cases requiring surgical treatment (1.3%), fetal body weight, visual analogue scale and anteroposterior renal pelvis diameter are higher.
本研究旨在确定无输尿管结石的孕妇中肾盂积水的比例和需要治疗的有症状病例，并分析这些病例的特征。
2018 年 2 月至 2019 年 4 月，前瞻性评估所有在妇产科门诊接受妊娠检查的孕妇。检测孕妇肾盂积水率、积水程度和侧别、有症状肾盂积水率、肾盂最大前后径和视觉模拟评分。对有症状的患者进行保守或手术治疗。对两组治疗结果进行 t 检验或卡方检验，采用 Pearson 或 Spermean 检验进行相关性分析。
共前瞻性随访 1026 例 18-45 岁（27.7±5.2 岁）孕妇。孕妇肾盂积水率为 28.7%，有症状肾盂积水率为 4.7%。在有症状的肾盂积水患者中，73.4%（3.5%总人数）接受保守治疗，26.5%（1.3%总人数）接受手术治疗。肾盂积水与妊娠周数呈正相关（p＜0.001），与视觉模拟评分（p＜0.001）和血尿呈正相关（p＜0.05）。肾盂积水与孕妇年龄（p＜0.05）和妊娠次数（p＜0.001）呈负相关。手术治疗组肾盂前后径（p＜0.001）、视觉模拟评分（p＜0.05）和胎儿体重值（p＜0.05）均高于保守治疗组。
无输尿管结石的孕妇中，大多数肾盂积水病例为无症状。大多数有症状的病例也可以保守治疗。在需要手术治疗的病例（1.3%）中，胎儿体重、视觉模拟评分和肾盂前后径更高。
