Hydronephrosis of Pregnancy
What is Hydropnephrosis?
In general, hydronephrosis refers to the swelling or dilation of the kidneys caused by an obstruction in the flow of urine, which then causes the urine to back up in the kidney's small tubes and central collecting area. This extra pressure in the kidneys can cause kidney damage, such as kidney stones, or long-standing distention in one or both kidneys can cause kidney failure. There are many different causes of such urine flow obstruction, including pregnancy.
What is Hydronephrosis Of Pregnancy?
It is well known that pregnant women are particularly susceptible to incontinence (leakage of urine) and to urinary tract infections (also known as UTIs or bladder infections). Normally UTIs are easily diagnosed and treated with antibiotics that are safe for both mom and baby.
A urinary condition that is less well known, however, is 'hydronephrosis of pregnancy,' or swelling of the kidneys. When the flow of urine is obstructed due to the growing fetus compressing the ureters, the blocked urine causes the kidneys to swell or become distended. Furthermore, hormonal changes in a pregnant women's body can aggravate this problem as the muscular contractions that normally move the urine along may be weaker.
Symptoms and Diagnosis
Since most cases of urine obstruction can be corrected, and since failure to do so can ultimately cause irreversible kidney damage and preterm birth, and can lead to hydronephrosis in the fetus, early detection is critical.
Hydropnephrosis often begins symptom-free, however over time women may begin to experience a dull, aching discomfort or they may feel excruciating pain.
Even without symptoms, a routine physical exam can indicate swelling in the kidney area. Doctors can then formally diagnose hydronephrosis of pregnancy by means of either bladder catheterization or an ultrasound. In bladder catheterization a hollow, flexible tube is inserted through the urethra, and if a large amount of urine is drained by the catheter from the bladder, this indicates an obstruction in either the urethra or the bladder outlet. An ultrasound can also determine whether the bladder is filled with an excessive quantity of urine.
Treatment of hydronephrosis normally consists of relieving the cause of obstruction. In the case of hydronephrosis of pregnancy, the condition usually clears by itself after a woman gives birth, although some distension may remain for some time afterwards. However since the condition can cause kidney damage and can also affect the fetus, pregnant women with hydronephrosis must be carefully monitored throughout their pregnancy.
If there is any indication that the condition is damaging the fetal kidney, pressure can be medially relieved by draining the kidney area with the use of a stint. In the most severe cases, women may have to have an early delivery.
Women can also relieve some of their discomfort or pain by not putting pressure on the affected area.