PROBLEMATIC RENAL CALCULI PRESENTING DURING PREGNANCY

Urinary tract calculi presenting during pregnancy are rare, with less than 0.1% of pregnancies being associated with stones, the vast majori ty being asymptomatic and a chance finding. We outline six cases treat ed over an 8-year period. They presented with combinations of pain, se psis and obstruction. Intervention was required in four cases: inserti on of antegrade nephrostomy, double-J stent, Dormia basket stone extra ction, open pyelolithotomy and induction of labour. In each case the p regnancy had a successful outcome. Renal colic can precipitate prematu re labour. Delayed diagnosis and intervention can result in permanent renal impairment. Ionising radiation and anaesthetic agents may be har mful during pregnancy. The problem is rarely encountered and we theref ore present information on the relative risks in each trimester of exp osure to the mother and fetus and present a clinical algorithm for the management of these patients.