Meria P, Anidjar M, Hermieu J F, Boccon-Gibod L
Service d'Urologie, Hôpital Bichat, Paris.
Prog Urol. 1993 Dec;3(6):937-43.
The incidence of renal stones in pregnant women is 1 in 1500. The diagnosis may be made more difficult by the particular anatomo-physiological conditions of pregnancy. Ultrasonography is not always sufficient to localise the stone and can be completed by intravenous urography, which is not contraindicated in pregnant women. In more than one half of cases, the stones are eliminated spontaneously during conservative treatment. The urologist may need to intervene in the case of complicated stones: internal or external urinary diversion is generally sufficient to palliate the problem until term. As extracorporeal lithotripsy is contraindicated in pregnant women, some authors recommend ureteroscopy or percutaneous nephrolithotomy when radical treatment is required. Surgical treatment is very rarely indicated.
孕妇肾结石的发病率为1/1500。妊娠特殊的解剖生理状况可能使诊断变得更加困难。超声检查并不总能确定结石的位置,可通过静脉尿路造影来完善检查,静脉尿路造影对孕妇并无禁忌。在超过半数的病例中,结石在保守治疗期间会自行排出。对于复杂结石,泌尿科医生可能需要进行干预:一般来说,体内或体外尿液改道足以缓解问题直至足月。由于孕妇禁忌进行体外冲击波碎石术,一些作者建议在需要进行根治性治疗时采用输尿管镜检查或经皮肾镜取石术。手术治疗很少被采用。