Kidney stones during pregnancy: causes and complications. An attack of renal colic in a pregnant woman: tactics of action. Drugs to reduce inflammation and remove stones

• Reasons for the formation of kidney stones
• Symptoms of stone formation
• Treatment of the disease

Diagnosis urolithiasis most often occurs on recent months pregnancy. This is due to the fact that in the urine of a woman there is an increased content of calcium, which is absorbed by the kidneys. But because of him a large number kidneys fail. As a rule, kidney stones during pregnancy are formed if the woman's body was present before pregnancy. hidden form urolithiasis.

Reasons for the formation of kidney stones

The main reason for the formation of sand, and then stones, is a violation of the outflow of urine from the kidneys. Such violations are characteristic of the 2nd and 3rd trimesters of pregnancy. The fetus increases to such a size that it presses on the ureters and kidneys, causing stagnation of urine. A long retention of urine in the body is also a good environment for the development of pathogens. An increase in their number leads to pyelonephritis in pregnant women.

Another reason that contributes to the development of urolithiasis is increased concentration urine. Most often it occurs due to severe edema caused by pathological disorders of the kidneys. Edema forces a pregnant woman to reduce the amount of consumption daily allowance water, which leads to a decrease in urine volume, but an increase in its concentration.

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Symptoms of stone formation

Every expectant mother should be aware of the symptoms that occur with urolithiasis. Timely detection and treatment of the disease will allow you to feel good throughout the pregnancy.

The characteristic symptoms of urolithiasis in pregnant women is the presence of pain in the kidneys. Initially, the pain is localized in the lumbar region and gradually moves to the ureters, giving to the groin.

Kidney stones during pregnancy can cause difficult and painful urination if they move spontaneously. During the period of gestation, a woman changes significantly her hormonal background which relaxes the muscles abdominal cavity, ureters and pelvis, which provokes the movement of stones and sand.

During this period, urine may be stained in pink color due to the content of blood in it. Blood occurs in urine due to the fact that a moving stone (sand) injures the kidney or urinary tract.

When the above symptoms appear, a pregnant woman should definitely consult a doctor, since the progression of the stone formation process leads to an increase in pain, renal colic and fever. There is also a threat to the baby:

• miscarriage;
• premature birth;
• infection of the placenta.

Lower back pain may be the cause of the development of other serious illnesses that can harm the baby.

Urolithiasis disease - frequent illness affecting the kidneys and urinary tract. Sometimes pregnant women suffer from it. main reason ailment - disorder metabolic processes. For the successful bearing of a child, it is important to know how to treat kidney stones during pregnancy.

If a woman is diagnosed with urolithiasis, this means that there are stones in the kidneys and urinary tract. If their size does not exceed three millimeters, we are talking about such a thing as sand. This is an accumulation of uric acid salts. They settle on the walls of the body and interfere with its normal functioning. If violations persist for a long time the whole body suffers. As a result, all sorts of problems appear during the period of bearing a child and after childbirth.

Urolithiasis of the kidneys

The main reason for the formation of sand in the kidneys during pregnancy is a violation of the water-salt balance. It usually begins before conception, and after it it worsens greatly. The urinary system is subjected to increased stress, as a result of which the risk of developing renal colic increases significantly. Kidney stones can also form for other reasons:

1. Low physical activity - many pregnant women prefer everything free time in bed, and big mistake. It is very important to keep the whole body in good shape and prevent a deficiency of calcium and phosphorus in the blood.
2. Unhealthy diet - it can increase the level of purines, which provoke the formation of kidney stones. This substance is rich in meat products.
3. Abuse of drinks, in which there are a lot of dyes and preservatives. During pregnancy, it is important to observe proper diet nutrition.
4. hereditary predisposition.
5. An exacerbation of a disease that is already in the body. The reason is hormonal imbalance.

The formation of sand in the kidneys is possible throughout pregnancy. After twenty weeks, the risk of developing the disease increases significantly, as the organs of the urinary system experience increased stress. In addition, during this period, metabolic processes are often disturbed, which is associated with changes in hormonal levels.

One of the features of urolithiasis is that for a long time it can proceed without any symptoms. In many women, sand is discovered by chance during ultrasound examination. Often the disease manifests itself only when the size of the stones, the size reaches five millimeters. In most patients, the first manifestation of the pathology is an attack of renal colic. Kidney stones can be recognized by the following signs:

• stupid It's a dull pain in the lower back;
• frequent urge to go to the toilet;
• change in urine color.

During pregnancy, women regularly go to the doctor, and first pass a urine test, so it is very easy to notice its turbidity. Further actions depend on the results of the analysis. If the shade of urine changes, and the condition worsens, you should definitely talk to the doctor. Symptoms of the disease include the following manifestations:

1. Blood in urine - moving into bladder stones can injure the urinary tract.
2. Renal colic - accompanied by unbearable pain. It is caused by blockage of the ureters, resulting in the accumulation of urine in the kidney.
3. Painful syndrome during urination clear sign the fact that stones or sand come out of the body. But at the same time they scratch the urethra.

Severe pain in the kidneys and urine with blood are red flags

Symptoms of the disease are found in expectant mothers in the period from the twelfth to the sixteenth week, sometimes a few weeks before the birth of the baby. A pregnant woman suffers from a sharp paroxysmal pain. The aggravation occurs due to the heavy load that almost all organs are exposed to. Sometimes problems are diagnosed against the background of the development of pyelonephritis.

Complications

Sand in the kidneys is the first stage of urolithiasis. If ignored this phenomenon, it will progress and lead to the formation of large stones and an attack of renal colic. The latter is characterized by:

• severe pain in the lumbar region;
• discomfort when urinating;
• urinary retention;
• impurities of blood in urine;
• nausea and vomiting;
• high body temperature.

The attack ends when the stone comes out or changes its position in the urinary tract. During pregnancy, the attack is not so severe. The explanation is very simple - the physiological expansion of the renal pelvis. Sometimes the stone comes out almost painlessly.

Kidney stones and pregnancy are a very dangerous combination that poses a threat not only to future mother but also for her baby. To the main negative consequences can be attributed:

• spontaneous abortion against the background of renal colic;
• joining the disease with an infection that can infect the fetus;
• stasis of urine - provokes the development dangerous pathology- pyelonephritis.

There are certain complications for the fetus in the presence of kidney stones

During an attack, all muscles contract, and the tone of the uterus increases. Overexertion leads to placental abruption, miscarriage or premature birth. The presence of stones in the kidneys and bladder is an obstacle to natural childbirth, so doctors often prescribe to the expectant mother C-section. Any inflammatory process dangerous for both the woman and the unborn child, therefore, when anxiety symptoms I need to urgently go to the doctor.

Treatment of sand and kidney stones is aimed at relieving pain in renal colic and eliminating the focus of infection. It is important to remember that pregnant women should not take many medicines.

Medical treatment

When a woman is faced with a problem, the only question that worries her is what to do if stones appear in the kidneys during pregnancy. If the neoplasms are small enough - no more than three millimeters, conservative therapy is carried out. As a result, the stones can come out on their own within one month. To speed up this process, a doctor may prescribe drugs to a pregnant woman such as:

1. Antispasmodics - Drotaverine or Papaverine. They relax the muscles of the urinary tract.
2. Analgesics - quickly relieve pain, but require caution in use in the first and last trimester.
3. Antibacterial agents - are prescribed for concomitant inflammation in the kidneys.
4. Herbal diuretics - Kanefron, Brusniver. These drugs improve the outflow of urine.

Only the attending physician can choose a treatment that will not harm the mother and the unborn child.

IN Lately homeopathic medicines are gaining popularity. They have natural composition therefore safe for the woman and the fetus. At the same time, medicines normalize metabolic processes. To enhance the effect of the expectant mother, treatment is recommended herbal preparations. But since many plants are prohibited during pregnancy, only a doctor can choose a specific one.

Dieting

During treatment and thereafter, it is important to change habitual image life.

If kidney sand is first diagnosed during pregnancy, it is necessary to determine the cause of the problems and adjust the diet:

1. Limit salt intake to five grams per day.
2. Increase the amount of fluid you drink to two liters per day.
3. Avoid salty, spicy and spicy foods.
4. To live an active lifestyle.

During pregnancy, you can drink berry fruit drinks, dried fruit compote, weak green tea, mineral water without gas. Any drinks should be warm or slightly chilled. In tea, you can dilute a little sugar or honey. The liquid should be drunk in small portions throughout the day.

Surgery

In case of severe inflammation and in the absence of results from conservative therapy, an operation is performed. Undoubtedly, such manipulations are extremely dangerous for pregnancy and can provoke its termination. But if the expected harm from the operation is much less than the risk of losing the baby, the operation is quite possible.

In some cases, it is necessary to surgical intervention

Surgery is performed under general anesthesia. During the operation, all calculi are removed, as a result of which it becomes possible to save the child and give birth to him in fixed time. If urolithiasis manifests itself for a period of thirty-six weeks, labor is stimulated, and the stones are removed after the baby is born.

What to do with renal colic

An attack of urolithiasis always begins suddenly and develops rapidly. In such a situation, you need to call a team of doctors, and before her arrival, give the woman an antispasmodic - he will relieve the pain. During pregnancy, it is allowed to use No-shpu and Papaverine. You can put a Nitroglycerin tablet under the tongue - it relaxes the muscles of smooth muscles. Before the doctor arrives, you need to monitor the volume of urine excreted, which must be collected for further research. During an attack it is strictly forbidden:

• warm the affected areas with a hot heating pad;
• take a bath;
• use drugs that contain narcotic substances.

Prevention

To prevent the development of urolithiasis and the formation of sand in the kidneys, it is enough to follow simple recommendations:

• eliminate harmful foods from the diet;
• observe the drinking regime;
• increase motor activity;
• treat any diseases in a timely manner;
• give up bad habits;
• control your weight.

Compliance with these simple rules help avoid problems. Better yet, pass comprehensive examination at the stage of pregnancy planning. If stones are found, they can be disposed of in the most appropriate way.

Recently, more and more kidney stones are detected during pregnancy. The appearance of this disease in a woman in position contributes a lot to hormonal changes in the body. ICD can manifest itself in different ways, so you need to clearly understand if a kidney stone is found during pregnancy, how dangerous this condition is and what it can threaten.

How does ICD manifest during pregnancy?

A woman who is carrying a child must definitely listen carefully to her condition, and when the slightest sign trouble go to the doctor for examination and treatment. The sooner it is started, the better the outcome. So, you should beware if:

1. There was pain in the lumbar region. It should not be ignored, because if it is a sign of a kidney stone, then the symptoms will only intensify, and the calculus will grow. For given state characteristic sharp pains cramping nature, which radiate to groin. But such sensations can be a sign of something else. pathological condition therefore require a visit to a specialist for differential diagnosis.

1. There was hematuria. During pregnancy, a woman undergoes physiological relaxation of smooth muscles. Therefore, the ureters, pyelocaliceal segment of the kidneys and the bladder are in a more relaxed state. As a result, the calculus may begin to come out along urinary tract. Bladder stones during pregnancy are detected as a result of their leaching from the kidney with urine. Sand and stone fragments sometimes hurt inner surface urinary tract, resulting in blood in the urine.

1. Appeared discomfort during emptying of the bladder. The irritation that the bladder and urethra experiences when small stones and sand pass out causes pain when urinating. If an infection joins at this moment, then the woman feels chills, her temperature rises, sometimes there is nausea and bloating.

Why stones form

The formation of stones during the carrying of the fetus does not occur for no reason, it happens as a result of the following conditions:

• the presence of small formations or sand that were not noticed before pregnancy;

• metabolic disorders, especially with low motor activity in a pregnant woman;

• sometimes, with an increase in the load on the kidneys, a pregnant woman develops edema, which leads to a restriction in fluid intake and an increase in urine concentration;

• irrational nutrition with a predominance of canned foods and products fast food, lack of sufficient fresh vegetables and fruits.

Most often, if the disease occurs during pregnancy, it occurs as a result of calcium deposition on later dates, because in this position it is much more slowly excreted from the body.

In other cases, the causes of the development of KSD during gestation are the same as for other people:

• urinary tract anomalies;

• kidney inflammation;

• metabolic disorder;

• endocrine pathologies;

• some diseases of the nervous system.

Complications of ICD

If a woman has a kidney stone during pregnancy, treatment should begin immediately, otherwise the following complications will occur:

1. Expressed pain syndrome by the type of renal colic, which can result in premature birth or miscarriage.

1. The addition of an infection that often accompanies ICD can lead to infection of the unborn baby or placenta. The condition usually aggravates the decrease in the immune forces of the expectant mother.

1. Stagnation of urine occurs, which leads to the development of hydronephrosis or pyelonephritis. It can also provoke an increased growth of old and the appearance of new stones. Especially often this happens if a stone occurs in the ureter during pregnancy. It prevents fluid from flowing freely from the kidney to the bladder.

How to treat

Treatment of stones during pregnancy conservative method. A radical solution in the form of surgical intervention to remove stones is used only in the very last resort- with development kidney failure or accession of a purulent process with the risk of infection. As a rule, if a kidney stone is 4 mm during pregnancy, and there are no signs of complications, then assistance is provided medical methods and setting the right diet.

Medicines

You can stop an attack of renal colic using antispasmodics or analgesics. In the absence of effectiveness from such treatment, a woman is given a novocaine blockade, and urine is released by catheterization.

Diet

Very important role diet plays a role in stopping the growth of stones and preventing the appearance of new stones. It is appointed only by a specialist, depending on the type of formations:

1. With oxalate stones, meat, poultry and a small amount of fish are used as food. All types of milk and dairy products, non-acidic fruits, eggs, compotes and jelly are not prohibited. All types of broths are excluded, except for vegetable, smoked meats, some spicy dishes (horseradish, mustard), carrots, tomatoes and cabbage. Consumption of sweets, cocoa and coffee is not recommended.

1. If a pregnant woman has urates, she can eat dairy products, bread, fish or boiled meat, ripe fruits and berries of non-acidic varieties, and any vegetables. You can consume bread, no more than one egg a day, cereals and pasta (with the exception of buckwheat porridge). Broths, sauces, canned food, pickles and smoked dishes are subject to exception. You can not eat fried meat, sour foods, sorrel, spinach, legumes.

1. If found during pregnancy phosphate stones, then you need to eat acidic foods (fruits and berries), any cereals, but you should cook without milk. You can use honey, bread and bakery products. Do not serve fish, any dairy products, spices, smoked products, salads, canned foods, vegetables.

Many expectant mothers, when stones are found, wonder what if there are kidney stones during pregnancy, how to give birth. The answer to this question can be given in each individual case only by a specialist. In most cases, childbirth is normal, and in the presence of large stones, the main treatment is prescribed after the birth of the baby. But it is best to plan pregnancy in advance, and treat all diseases so that they do not worsen and create problems later.

At 12-16 weeks, the existing ICD or urolithiasis during pregnancy is manifested by bouts of cramping pain, that is, it worsens. This happens due to the additional load on the urinary system. Regular monitoring by a nephrologist prevents the risks of miscarriage. Without concomitant complications, the disease does not pose a danger to a woman during the gestational period.

Exacerbation of KSD in a pregnant woman: treat or wait for childbirth?

Emergence factors

Urolithiasis is the deposition of potassium, sodium, calcium salts in the kidneys, from which solid formations are formed. The disease develops as a result of insufficient water intake, due to which the metabolism is disturbed, and calculi appear in the human genitourinary system. If you do not pay attention to treatment, exacerbation of the disease leads to the loss of the kidney and fetus.

The attack begins with a sudden sharp pain that spreads from the lower back to the lower abdomen, may radiate to the thigh or leg. Discomfort can last from several hours to several days, accompanied by elevated temperature, vomiting, chills. The spasm usually goes away when the stone has already left the ureter or has changed its location.

What is dangerous exacerbation of urolithiasis?

Urolithiasis during pregnancy is exacerbated due to attacks of renal colic. With spasms, the uterus comes into hypertonicity, which is fraught with spontaneous miscarriage or premature delivery. With inflammation of the kidneys, when the health of the future mother and baby is in danger, the patient is subject to hospitalization and is under the supervision of specialists. Often, doctors decide on a caesarean section.

How is the diagnosis carried out?

To make a diagnosis, the doctor takes anamnesis, conducts external examination, tapping the lumbar region. Appointed:

• Urinalysis:
  • to determine the nature of the salts of stony formations;
  • on general indicators;
  • for parameter estimation according to the Nechiporenko method;
  • on bacterial flora (sowing).
• Biochemistry with general analysis blood.
• Ultrasound of the kidneys and ureter to determine the size, shape and location of stones.
• MRI of the genitourinary system (as a last resort).

Treatment requires a special approach

Pregnant women diagnosed with urolithiasis are examined by a urologist and consulted by an obstetrician. Depending on the diameter of the stones and the progression of urolithiasis, medical (conservative) treatment or surgery is performed. The patient is selected an individual diet with a certain set of allowed and prohibited foods.

Urolithiasis is called the disease of civilization, every year it occurs more and more often. This fact is explained by the conditions modern life, especially physical inactivity, leading to a violation phosphorus-calcium metabolism, and food with a high content of purines (various processed meat products), which precipitate uric acid salts ( urates). Nowadays, kidney stones during pregnancy are quite common, they can be before pregnancy, and occur during it. Urolithiasis itself does not harm the development of the fetus and the course of pregnancy, if it is not complicated by infection. More often the problem is severe colic with fever leading to miscarriage.

Urolithiasis during pregnancy is characterized by more frequent bouts of colic and the appearance of blood in the urine due to the spontaneous discharge of stones or sand. Under the action of hormones, all abdominal organs expand and relax, including the renal pelvis and ureters, which causes the movement of stones with urine flow. Therefore, the stones move away on their own up to 30-34 weeks of pregnancy, until the uterus is too enlarged. Since the stagnation of urine increases, in pregnant women with urolithiasis already in the first trimester.

Pain with kidney stones in pregnant women is pronounced at the moment, they are strong, cramping - in the lumbar region and then move along the ureter, give to the thigh, groin, genitals. Urine is excreted with difficulty, with cutting and frequent urges for urination. The temperature may rise, chills, nausea, vomiting, flatulence may appear. Severe colic, infection, or impaired kidney function can cause a pregnancy to be terminated ( spontaneous abortion), therefore, with an exacerbation of the disease, a pregnant woman is hospitalized.

Exacerbation of urolithiasis in women during pregnancy is prevented by diet. With urate stones ( uric acid diathesis) the consumption of meat broth, fried meat products is limited, the amount of vegetable and dairy food is increased. At phosphate diathesis reduce the intake of calcium salts, that is, exclude eggs, dairy products, green vegetables, legumes, potatoes, and add meat, cereals, fruits. At oxalic acid diathesis food should not precipitate oxalates, therefore exclude sorrel, lettuce, tomatoes, legumes, nuts, eggs, cocoa, milk. The diet is adjusted according to the doctor's prescription.

Drug therapy is required to eliminate pain during an attack, for which injections of papaverine, no-shpa, baralgin or platifillin are used, and in severe cases, narcotic analgesics. With insufficient effect, a novocaine blockade of the round ligaments of the uterus is carried out and urine is diverted by a catheter. Antibiotics for urolithiasis in pregnant women are used strictly according to indications (pyelonephritis), when there is a risk of development severe complications. Sometimes in severe cases it is necessary to remove the stone, ureter or even the kidney. If the period is long, then a caesarean section is first performed, and then the kidney is removed. To avoid such consequences, it is necessary to remove the stones before pregnancy.