Kidney stones during pregnancy - what to do. Are kidney stones dangerous during pregnancy? Urolithiasis in pregnant women

Urolithiasis during pregnancy Lately is becoming more and more widespread. The presence of this disease is a serious danger to both the fetus and the health of the woman. Therefore, it is very important to know the mechanism of the onset of the disease, its manifestations and preventive measures in order to avoid negative consequences that she can evoke.

Pregnancy is special and very important period in the life of every woman. At this time, her body undergoes significant changes and experiences great stress. In this regard, the risk of exacerbation of various chronic diseases is significantly increased. One of these negative manifestations can be urolithiasis (urolithiasis).

Urolithiasis in pregnant women is recorded in 0.8% of women. Although this figure is small, neglect the danger of development this disease not worth it. It occurs mainly due to problems with water-salt metabolism. But there are other reasons that contribute to the occurrence of the disease.

These include:

• bad heredity;
• malnutrition, in particular, excessive passion for meat products;
• pathological changes hormonal background;
• the presence of inflammatory processes in the body;
• Availability bacterial infection in the urine;
• avitaminosis;
• problems with the work of the stomach and intestines;
• chronic diseases kidneys;
• gout;
• body dehydration.

During pregnancy, the risk of developing urolithiasis also increases due to a sedentary lifestyle, which is often observed in the last months of its course.

It should also be noted that in the case of a chronic asymptomatic course of the disease, urolithiasis and pregnancy is not a dangerous combination. The threat arises only in case of exacerbation of the disease.

Symptoms

Most dangerous periods in terms of exacerbation of urolithiasis are the interval from 12 to 16 weeks, as well as the last month of pregnancy. It is at this time that the load on the kidneys and urinary tract reaches its peak. At the same time, the tone of the renal pelvis decreases, and the formed stones begin to move along the ureters.

The patient has the following symptoms:

1. Renal colic. It manifests itself as a sharp pain in the lumbar region. The pain has the character of an attack. It intensifies at the slightest physical activity, when trying to change posture or while walking.
2. The appearance of blood in the urine. This is due to the fact that the stones during their advance injure the sharp edges of the ureteral wall. The amount of blood may vary. Sometimes only individual droplets are visible in the urine, but it also happens that it is profusely stained with blood.
3. Frequent calls to urination. When it is performed, the patient feels pain.

In addition to the symptoms listed above, patients may experience fever, chills. There may also be flatulence and nausea, turning into vomiting.

After the stone comes out or changes its position, renal colic stops. If the stone has big sizes- it can block the urinary tract. The patient cannot urinate normally and experiences a dull pain in the lower back.

Frequent repetition of attacks of urolithiasis is dangerous for a pregnant woman, as it can provoke a miscarriage or premature birth. In addition, the presence of stones can provoke a disease such as pyelonephritis. IN this case the infection can affect not only the body of a woman, but also the fetus.

During pregnancy, the treatment of urolithiasis is complicated. It is impossible to apply the standard scheme to a pregnant woman, since it is possible to harm the unborn child. Which drugs and non-drug methods will be used depends on how long the pregnant woman is and how severe the disease is.

The course of treatment for urolithiasis is aimed at eliminating inflammatory process. At the same time, the process of dissolution of stones and their removal from the body takes place. During attacks, drugs are used to help relieve spasm of the urinary tract and reduce pain. If there is a complication in the form of pyelonephritis, antibiotic therapy is performed.

important place in the treatment of urolithiasis in pregnant women, measures are taken to prevent attacks renal colic.

To avoid its occurrence, a woman should:

• exclude fried, salty and spicy foods from your diet;
• drink more fluids (it is recommended to drink at least 2 liters of water during the day);
• completely give up alcohol and smoking;
• get enough sleep (at least 8 hours);
• provide yourself with regular physical activity.

Phytotherapy is effective in the treatment of urolithiasis. There are currently a number of medical preparations created on the basis of well-known medicinal plants. These are drugs such as Cyston, Cystenal, Kanefron and other drugs.

good impact mineral waters are used in the treatment of urolithiasis. What kind of water can be used depends on the acid-base balance of the urine and the type of stones that are found in the patient. Therefore, in no case should you start treatment mineral water independently, without a doctor's prescription. If the urine is dominated acidic environment- suitable alkaline mineral water. Otherwise, acidic water is prescribed. It also helps to remove phosphate stones from the body. Alkaline water is suitable for removing urate stones.

If conservative treatment does not give results, with urolithiasis it is possible to use surgical intervention.

It must be emphasized that it is a last resort and is used when the risk of miscarriage or premature birth is very high. To protect the fetus, local or short-term general anesthesia is used. If the pregnancy is more than 36 weeks, then before removing the stones, delivery is done by caesarean section.

Expectant mothers often note pain in the ureter during pregnancy. This is primarily due to active growth fetus, which puts pressure on many organs. During pregnancy, a woman's body is rebuilt, which can provoke the development of some pathological processes. Therefore, with any discomfort and manifestations of pain, it is advisable to consult a doctor.

Pain in the ureters during pregnancy may have a physiological explanation, but sometimes it is a pathology.

Causes of pain in the ureter during pregnancy

As the fetus grows, the size of the uterus increases significantly, and it exerts strong pressure on nearby organs. This causes discomfort and pain. Such changes are considered a natural physiological phenomenon. There are a number of factors that cause pain in the ureter during pregnancy:

• Pyelonephritis. dangerous disease infectious nature, which can threaten the life of the fetus and lead to premature birth. During the growth of the uterus, there is a strong pressure on the ureters, which prevents the normal output of urine from the kidneys. Because of this, stagnation of urine occurs, which leads to the multiplication of pathogens and the development of an inflammatory process in the renal pelvis.
• Pinching of the ureter. Pathology does not pose a danger to the health of both the mother and the child. It occurs due to the strong pressure of the enlarged uterus. This condition cannot be avoided, but pain can be reduced with the help of medicines taken on the advice of a physician. And also to stop the pain will help special physical exercise designed to reduce internal pressure.
• Ureteritis. This disease is due to If pathogenic microorganisms became the cause, then the disease has an infectious nature. With an allergic reaction and injuries, non-infectious ureteritis develops.
• Urolithiasis disease. It rarely manifests itself during pregnancy, but it is very dangerous for its complications and periodic relapses. In remission, it does no harm. Provoke the formation of stones can malnutrition, violation metabolic processes, concomitant diseases, problems with water-salt balance.

The nature of pain

The strength and localization of pain depends on the severity and development of the disease that provoked similar condition. Sometimes the symptoms of the disease are practically not manifested. In this case, there is no cause for concern. If pain syndrome pronounced, and its intensity increases, it is necessary to take immediate measures to eliminate it.

Pain in the ureters during pregnancy can be rare or aching and frequent.

Based on the main cause of pain, they are moderate, cutting and dull. Localization of unpleasant sensations extends to the hypochondrium and spine. Often, pregnant women are concerned about pain in the lower abdomen and right side. Attacks can occur during physical activity and subside in a calm state. Special attention you need to pay attention to the presence of other symptoms that may indicate the development of severe pathology. These include fever, nausea, profuse sweating, fever, blood in the urine.

Urolithiasis during pregnancy is not the most common pathology (no more than 1%), but it can affect any woman. If on initial stage the disease is not capable of disrupting the bearing of a child, then in complicated cases significant problems may arise.

This indicates the need to take health seriously. Only a doctor can assess the degree of danger, and determine whether urolithiasis and pregnancy are compatible in each case.

The essence of the problem

Urolithiasis, or urolithiasis, is a pathology associated with the formation of hard stones (stones) in the organs related to the urinary system. As a rule, it involves damage to the ureter and Bladder, but is also associated with nephrolithiasis, i.e. kidney disease. It is nephrolithiasis that often becomes a provocateur for lowering stones from the kidneys to the underlying organs.

Calculi in the urinary organs are the result of a violation of metabolic processes. Insoluble salts precipitate (urates, phosphates, oxalates, etc.), which become the nucleus of crystallization, around which solid formations are formed. The manifestation of such a pathology is associated with the size and number of stones.

At certain conditions they can move and also block the urethra. Small stones are able to go out with urine, but large formations gradually accumulate in the organs.

Pregnancy of a woman in itself cannot contribute to the onset of the disease. Urolithiasis begins long before conception, and the processes occurring in female body, only activate the growth of calculi. greatest danger pregnancy causes pyelonephritis, which is usually accompanied by urolithiasis in pregnant women. A certain pattern in the detection of this disease after conception is due to the fact that the greatest spread of the disease occurs at the age of 20-35 years, i.e. the most active age for childbearing.

Etiology of pathology

The treatment of any disease first of all begins with the elimination of the causes that give rise to it. That is why, despite the onset of urolithiasis even before the period under consideration, it is important to identify and exclude provoking factors. Important role in the etiological mechanism, it is assigned to the hereditary factor.

However, in addition to it, a number of other reasons should be highlighted:

• malnutrition with a predominance of spicy and acidic foods that increase uric acidity, as well as excessive consumption of animal proteins and refined sugar;
• vitamin deficiency;
• metabolic diseases;
• bone pathologies and injuries;
• diseases of the gastrointestinal system of a chronic nature (enteritis, pancreatitis);
• pathology of the kidneys and genitourinary system (pyelonephritis, cystitis).

Symptomatic manifestations

The symptomatic manifestation of urolithiasis depends on the localization of the lesion, the nature of the stones and their size. First of all, the disease is associated with a pain syndrome of a dull, aching nature in the chronic course of the pathology. Localization of the focus in the upper part of the urinary tract causes paroxysmal pain in the lumbar region and in the area of ​​the ureter.

Often there is irradiation to the femur and inguinal zone, external genitalia. With the formation of stones in the lower part of the ureter, the pain reaches the labia majora, while there are problems with urination - a sharp decrease in urination, up to its complete cessation.

The growth in the size of the stones leads to blockage of the lumen of the ureter, which leads to the accumulation of urine in the kidneys and the manifestation of acute cramping pain in the lumbar region with spread to the abdomen. These are the so-called renal colic, which can last for hours. This complication is accompanied by chills, fever, nausea, vomiting, flatulence.

Other hallmark is the appearance of blood impurities in the urine (hematuria). This symptom is the result mechanical damage channel walls when moving hard and sharp stones. Most often, hematuria is fixed at the final stage of renal colic and after exercise.

In addition, in the case of an inflammatory reaction, a manifestation of pyuria is possible. Together with urine, small pebbles in the form of sand can come out.

When forming, in addition to blood impurities in the urine, a pain syndrome appears in the lower abdomen with an increase in movement and at the time of urination. There is an increase in the urge to urinate, especially acute when walking, shaking or exertion.

The specifics of the course of the disease in pregnant women

Urolithiasis in pregnant women has a number of features:

1. Pathology almost never arises during pregnancy - lesions appeared significantly before conception. This conclusion is facilitated by a physiological nuance: during pregnancy, colloidal and crystalloid urinary balance is quite clearly maintained in the body, which does not allow the formation of salt deposits, as well as an increased content of silicon, which plays a protective role.
2. In pregnant women, the appearance of renal colic is more frequent, but the pain syndrome is less pronounced.
3. The movement of stones, as a rule, is noted in the first 4 months after conception and on last month before childbirth, which is caused by a decrease in the tone of the renal pelvis and ureter. It is during these periods that renal colic is most likely.
4. hormonal processes and low tone the muscles of the urinary tract in the first trimester of pregnancy contribute to the active spontaneous removal of small stones. In the following periods, the enlarged uterus compresses the channels, stopping this process. Self breeding calculus may resume before childbirth.
5. The uncomplicated form of urolithiasis does not affect the development of the fetus in any way and general state women. Threats of pregnancy begin when signs of pyelitis, or pyelonephritis, appear. In this case, there is a risk of abortion, infection, increased toxicosis.
6. Taking tocolytics leads to a decrease uterine tone and provokes the movement of stones, which is dangerous for the fetus.
7. When diagnosing urolithiasis in a pregnant woman, X-ray methods and chromocystoscopy should not be used.

Principles of disease treatment

Treatment of urolithiasis during pregnancy is complicated by concern for normal development fetus, which requires careful administration medications. Pathology therapy begins with providing an appropriate diet, which depends on the type of lesion.

When optimizing nutrition, the following recommendations should be considered:

1. With the uric acid mechanism, it is necessary to sharply limit the consumption of fried meat, meat broth. In nutrition, preference is given to dairy products and plant foods. Boiled fish and lean meat can be consumed no more than every other day.
2. With the phosphoric acid mechanism, the consumption of eggs and dairy products is excluded. The consumption of greens, potatoes, peas, and beans is significantly reduced. You can enter into the diet: meat, sweets, cereals, fruits, butter, liver, carrots, fish oil.
3. With the oxalic acid mechanism, the diet should not include products that provoke the formation of oxalates, namely milk, eggs, legumes, nuts, sorrel, black tea, tomatoes, cocoa. It is advisable to introduce products with the effect of alkalizing urine into the menu: apples, pears, apricots, peaches, quinces, watermelons.

Drug therapy is aimed at pain relief, removal of stones, normalization of the process of urination, exclusion of dehydration. Spasmolytic drugs are widely used: papaverine hydrochloride solution (2%), No-shpa, Baralgin. A positive effect is provided by drugs that relax the smooth muscles of the ureters: Cystenal (single use), Avisan. When signs of pyelonephritis appear, they are prescribed antibacterial agents, which are approved for use during pregnancy and always taking into account its term.

Particular attention in the treatment is given to phytotherapeutic drugs that do not have side effects. You can recommend such pharmacy options: Cyston, Cystenal, Fitolizin, Pinabine, Olimetin. The use of medicinal mineral waters will help maintain the water balance. The following compositions should be highlighted: mineral water from Zheleznovodsk, Kislovodsk (with phosphate stones); Essentuki, Borjomi (urate stones); water from Pyatigorsk and Essentuki (oxalates).

In some cases of acute urolithiasis, it is indicated surgical treatment. Modern technologies allow for the most sparing operations, incl. with transvesical and transvaginal access. Nephrectomy is performed in critical circumstances. The optimal time for surgical intervention is 16-19 weeks of gestation, when the risk of fetal loss during the operation is minimal.

Urolithiasis during pregnancy is a manifestation of previous lesions. Most often, the pathology does not violate the development of the fetus, which makes it possible for a full-fledged birth. In the case of a complicated course of the disease, it is necessary to carry out adequate treatment.
 

Future mothers know the hackneyed phrase that pregnant women have different pain sensations in the body. Pain in the ureter during pregnancy can be the cause of fetal growth, but it is not superfluous to seek the advice of a specialist. During this period, the entire body is rebuilt for bearing the fetus. Central nervous system, gastrointestinal, musculoskeletal, lymphatic and immune system are subject to change. Particular changes occur in the work of the kidneys.

Causes of pain in the ureters during pregnancy

The uterus increases in size and begins to put pressure on the nearest organs, which causes unpleasant and even pain, although this is not yet a reason to sound the alarm. The main causes of pain in the ureters are:

• pinching of the ureter;
• ureteritis (inflammation of the ureter);
• renal colic (with stones in the ureter)
• pyelonephritis (inflammation of the renal pelvis).

Pinching of the right ureter occurs with the growth of the fetus and pressure on the organs that surround it. It is impossible to avoid this, but it is better to stop pain after consulting with your doctor. The doctor can prescribe both harmless medications and physical exercises to help relax the muscles and change pressure distribution points. This reason is not dangerous for the mother and the unborn child, but does not cancel the trip to the gynecologist.

More dangerous is the occurrence of symptomatic pain with inflammation of the ureter - ureteritis. It is of two types - infectious and non-infectious. If the cause of its occurrence are microorganisms that live in the vagina or urethra (for example, gonococi, ureaplasmas, chlamydia), then this is an infectious ureteritis. The cause of non-infectious inflammation can be allergic reactions and injury.

Urolithiasis and pyelonephritis

Attacks of renal colic are an indication for immediate hospitalization.

A serious problem is the formation of kidney stones and urinary tract. Urolithiasis is considered a rare occurrence in pregnancy. But the most dangerous are the complications of the disease and sudden exacerbations. If this ailment does not manifest itself, then no harm is done to the fetus or the woman's body. To provoke the formation of kidney stones can be a deficiency of vitamins, a violation of the water-salt balance, heredity to such a pathology, chronic diseases gastrointestinal tract, wrong image life and nutrition. But a sedentary lifestyle affects the occurrence of renal colic.

Pyelonephritis can cause abortion and fetal death. Therefore, this disease is very serious and requires heightened attention. The uterus is so squeezing internal organs, which makes it difficult for the ureters, which remove urine from the kidneys. Urine stagnates in the renal pelvis and, as a result, begin to develop infectious diseases, and the inflammatory process progresses.

The nature of pain and associated symptoms

Depending on the stage of the course of the disease and its nature, a pregnant woman acutely feels pain symptoms and sometimes does not feel at all. If the problem does not manifest itself, then its effect on the body of the mother and the unborn child is insignificant and does not lead to dire consequences. If the symptoms are felt acutely, then it is urgently necessary to alleviate it and stop the exacerbation.

Prolonged pain in pregnancy is alarm symptom, which signals that you need to see a doctor.

Based on what became the reason for the onset of pain, its nature and place are different. It can be tolerant (mild), cutting, dull. The sensation can be localized under the ribs or in the spine. Often a pregnant woman has pain in the right side or lower abdomen. With sudden movements and physical exertion, the pain intensifies or occurs abruptly. Seizures may come and go in cycles throughout the day. The nature of pain in the ureters is completely different in each individual case, so it is difficult to diagnose the disease.