Pregnancy has been termed as one of the most beautiful trips that one could ever take as a woman. However, what happens when the trip is broken by a sharp stabbing pain in the side or the back? To certain pregnant women, that kind of pain is not necessarily a muscle spasm, but a kidney stone. The big question that comes next is; Do I have to treat this? Or can I do it later, after my baby is born?
This is a more widespread dilemma than you may imagine. Although it is not a very common condition, kidney stones during pregnancy can be very unpleasant. The development of hormones, the pressure of the increased uterus, and a slow down of the urinary stream may be reasons that lead to the development of stones. However, when one has a baby in the womb, there are all the extra layers of cuts to every medical decision you have to make.
It is better to sweat and wait, or now take action? Let’s explore.
Comprehending the Problem: The Reason Why Kids Stones Occur During Pregnancy
During pregnancy, there are a number of physiological and hormonal changes that might pose a risk of having kidney stones:
- Dilution of the urine by accretion of calcium
- Reduced bladder tone and reduced urinary voiding speed
- Dilation of the urinary tract secondary to the effect of progesterone causing stasis
- Restriction of movements at late stages
Calcium phosphate and calcium oxalate stones are the most prevalent stones and occur during pregnancy. They may be of different sizes, localization, and the level of symptoms.
Symptoms to Watch Out For:
- Sudden, intense pain in your back or side
- Pain that may spread to the groin or lower abdomen
- Nausea and vomiting
- Blood in urine
- Burning sensation while urinating
These symptoms can mimic other pregnancy discomforts and also labor pains, and therefore, it is important to get an accurate diagnosis.
Is It Safe To Wait To Pass The Stone?
The answer is not black and white. The answer to whether you can wait is a function of a few critical factors:
Structure and Location of the Calculus
- Stones < 5 mm usually spontaneously pass with a conservative approach.
- Stones that are stuck within the ureter, or causing obstruction, may not be able to pass, and may need to be removed.
Severity of Symptoms
- If the pain is bearable and there is no infection or obstruction, waiting is likely safe.
- If there is ongoing pain, fever, or kidney swelling, you will need emergency treatment.
Risk of Infection
If the stone is associated with a urinary tract infection, especially fever, it needs to be treated promptly. Infections during pregnancy can be bad for both mother and baby.
Stage of Pregnancy
- Non-invasive treatment is preferred in cases of first trimester with or without the risk of undermining the fetus growth.
- If intervention is necessary, in the second trimester is when it’s estimated to be the safest time, for other procedures.”
- In the third trimester, in women with no complications, stone removal may be postponed until after the baby is born.
Non-Surgical Management During Pregnancy
- Hydration and Observation
The initial management is hydration therapy for spontaneous stone passage. Neck stone movement is monitored closely using ultrasounds.
- Pain Management
It is safe to take drugs such as acetaminophen. Stronger painkillers or NSAIDs should normally be avoided (especially in the third trimester).
- Antibiotics (If Needed)
Antibiotics that are proven to be safe for pregnancy are given if infection is present.
- Ureteral Stent or Nephrostomy Tube
If there is a blockage or an infection that can’t wait, a stent or tube can be inserted to bypass the obstruction or drain an infection temporarily, until the baby is born.
What Happens After Delivery?
If you still have not passed the stone by the time you give birth, your urologist might suggest further care such as:
- RIRS (Retrograde Intrarenal Surgery) – a thin, flexible scope is passed through the urethra into the kidney. This is to locate and break stones.
- Ureteroscopy: A less invasive technique to remove or shatter the stone
- ESWL: Generally avoided in pregnancy; safe after delivery
- PCNL (Percutaneous Nephrolithotomy): Large and complex stones
When Waiting Isn’t a Choice
For all of the cases that can be treated conservatively, there are some red signals that mandate immediate action:
- Intractable vomiting or not able to eat/drink
- Fever or signs of sepsis
- Decreased kidney function
- Stone-induced preterm labor
It is appropriate advice to see an obstetrician and a urologist together for this condition.
Key Takeaways
- Not all kidney stones have to be removed right away in pregnancy.
- Many stones are amenable to conservative management, particularly when they are small and nonobstructive.
- There are safe ways to protect a mother and her baby if complications do occur.
- Follow-up therapy is important for any residual stones or recurrences.
Ask Dr. Deepanshu Gupta: Expert Advice
The management of kidney stones in pregnancy carries additional risk. The magic lies in determining the right diagnosis, in knowing how to closely monitor the patient and in the selective use of treatment of the person. Your management will depend on your symptoms, the size of your stones and how far along in your pregnancy you are.
Most females can deliver the kidney stones without any problems. If you have symptoms, or if you’re just worried, don’t drag your heels — early evaluation can be very reassuring.
Dr.Deeepanshu Gupta – the Super Specialist Urologist knows how to deal with complex Stones. From accurate diagnosis to personalized, pregnancy-safe treatment plans, he says he never loses sight of the simple truth that “when mom and baby is healthy,” a happy ending is quite often the outcome.
If you are pregnant and you have a kidney stone or frequent urinary issues, make an appointment with Dr. Gupta today. You health is in good hands.
First step in safe, expert care — and you and your baby deserve it.