Conservative Versus Surgical Management for Symptomatic Hydronephrosis Among Pregnant Women | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2025, Issue 3, March 2025 | ||||
| DOI: 10.58675/2682-339X.2883 | ||||
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| Authors | ||||
| Mohamed Gebreal; Mostafa Ghanim; Samir Galal | ||||
| Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: During pregnancy, changes occur in the morphology and physiology of the upper urinary tract. Some individuals may have symptoms as a result of these changes, and others may potentially develop pathological diseases. During pregnancy, systemic vascular resistance naturally falls along with increased cardiac output. Both the glomerular filtration rate and the renal blood flow increase by thirty percent. Serum urea and creatinine levels will consequently drop. Aim of the work: To compare the effectiveness of conservative and surgical approaches in treating pregnant women with acute, moderate, or severe symptomatic hydronephrosis. Patients and Methods: A prospective controlled study was conducted on 100 pregnant women diagnosed with symptomatic hydronephrosis who were admitted to the Obstetrics and Gynaecology department at Al-Azhar University during the study period from February 2022 to April 2023. Results: Among group A, there was a significant decrease among the severe group (8.18±2.52) than the moderate group (9.61±2.27) regarding serum BUN (P=0.044). On the other hand, the preterm labor and culture-positive rate did not significantly differ between the severe and moderate groups (P>0.05). Serum BUN, serum creatinine, WBC, and C-reactive protein did not significantly differ between group B's moderate and severe groups (P>0.05). Conclusion: Double pigtail stent implantation is an effective treatment for moderate to severe symptomatic hydronephrosis in pregnancy with a lower failure rate than conservative care. On the other hand, early or late problems may occur if ureteral stents are left in place for more than three months. Therefore, a cautious approach to treatment should remain the chosen course of action. | ||||
| Keywords | ||||
| conservative management; Moderate hydronephrosis; Severe hydronephrosis; Pregnancy | ||||
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