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Hydronephrosis is a common condition in pregnant women, occurring in up to 90% of all pregnancies. Knowing the effects of this condition and learning to deal with it is the first step towards a pregnancy that is more comfortable.
What is Hydronephrosis?
Hydronephrosis is a condition and not a disease. It is a structural or physiological condition that arises due to the way the uterus presses on the urinary bladder. The bladder is unable to discharge its contents due to the pressure and the urine then travels back and causes the kidney to swell. It is accompanied by pain and can affect one or both kidneys.
Hydronephrosis in pregnant women is mostly observed in the second trimester particularly between the 26th and 28th week of gestation. Hydronephrosis caused due to pregnancy will disappear on its own, typically within six weeks after the delivery. However, there have been cases where the condition has persisted and must be given medical attention.
Causes of Hydronephrosis During Pregnancy
There are several causes for the occurrence of hydronephrosis. These include:
- One of the most common causes of hydronephrosis is a blockage in one or both ureters. This is the tube that connects the kidneys to the urinary bladder. The blockage could be due to kidney stones, scarring or even blood clots.
- Tumours near or in the ureter
- Narrow ureters due to some birth defect
- During pregnancy, the leading cause of hydronephrosis is due to the pressure of the uterus on the bladder and ureter.
- One of the reasons for hydronephrosis during pregnancy is because of the increased production of pregnancy hormones that will cause the muscles to relax.
- Cancer of the urinary bladder and the cervix can also cause hydronephrosis.
- Ovarian vein syndrome
- Vesicoureteral Reflux
Hydronephrosis Signs And Symptoms in Pregnant Women
There are many signs you can keep a look out for when it comes to hydronephrosis. Remember that if you are pregnant, then the chances of this condition manifesting are very high. If you have the following symptoms when pregnant, then you must seek immediate medical help.
- Acute pain in the abdomen or back
- Vomiting and nausea
- Chronic UTI
- Colicky pain
- Pain in the chest
- Bloody urine
- Swelling particularly in the legs
- Increased frequency of urination
There are several methods your medical health practitioner will use to diagnose the condition. These methods will give her a more robust and comprehensive understanding of what is going on with your urinary system.
- An ultrasound is one of the most dependable methods of diagnosing hydronephrosis, especially if the cause is physiological. A variety of causes for the condition can be determined using this method including kidney stones and other obstructions.
- Urine analysis to determine if there is an infection in the urinary system that is affecting you.
- A blood test will be conducted to check for anaemia as it is one of the most common conditions in pregnant women.
- GFR and electrolyte analysis to check the proper functioning of the kidneys.
There are some risks associated with hydronephrosis that you must be aware of. It is possible that a spontaneous renal rupture will take place particularly if there is undue pressure on the kidneys. If your kidneys have had some previous damage, then the chances of a spontaneous renal rupture are much higher.
This condition should not be left untreated as it could cause the kidneys to permanently fail. Be sure to get regular check-ups that will monitor the health of your kidneys and the urinary system. Your doctor can develop a treatment plan that will ease the pressure on your kidneys.
Hydronephrosis Treatment in Pregnancy
The management of hydronephrosis in pregnancy is done carefully through different stages.
- The first step of treatment in cases of hydronephrosis is using a catheter to drain the urine from the bladder to ease the pressure off the kidneys.
- The next step in treatment is to focus on the underlying cause of the obstruction. Different causes will have different treatments. A kidney stone is treated differently than scarring on the ureter.
- Pregnancy-related hydronephrosis has no treatment. Only once the full term of the pregnancy is carried out will the pressure on the ureter and bladder ease up. During this period, draining the bladder using a catheter will help ease the pressure on the kidney.
Unfortunately, most renal disorders do not have symptoms. When it comes to avoiding severe hydronephrosis during pregnancy you must be diligent in maintaining your check-ups with the doctor. Be sure to get your kidneys scanned regularly along with urine and blood tests to scan for infections.
Discuss your concerns with your doctor and give her a full history of your medical health particularly if you have had previous renal disorders. You must check-in regularly with her and she will keep a look out for any warnings of renal disorders particularly that of mild hydronephrosis.
Hydronephrosis can be a painful experience during your pregnancy due to the undue pressure on the kidneys. The symptoms themselves can cause a lot of discomfort and you must visit your doctor to try treatment methods to relieve the pressure on your urinary system. Remember that most women suffer from this condition during pregnancy and you must keep an eye out for the symptoms mentioned above. You must seek immediate help if you experience fever, blood in the urine, and acute pain in the abdomen or back. If you have only one kidney then severe hydronephrosis could also prove to be fatal.