Severe early onset preeclampsia secondary to bilateral ureteral obstruction reversed by stenting

Background: Severe early onset preeclampsia might be reversed by correction of an underlying pathophysiologic condition. Case: A 22-year-old nullipara with a history of antivesicoureteral reflux s urgery in childhood presented at 23 weeks' gestation with severe headaches, hypertension, proteinuria, edema, and acute renal failure. Severe preeclam psia was diagnosed, and bilateral distal ureteral obstruction was documente d by cystoscopy, fluoroscopy, and retrograde pyelography. Bilateral uretera l stent placement completely resolved the preeclampsia and prolonged pregna ncy until term. Conclusion: Pregnant women with a history of antireflux surgery in childhoo d might be at risk for acute renal failure and severe preeclampsia caused b y bilateral ureteral obstruction. Ureteral stent placement might reverse ob struction, renal failure, and preeclampsia. (Obstet Gynecol 1999; 94:806-7. (C) 1999 by The American College of Obstetricians and Gynecologists.).