WOMENS-HEALTH Messages for July, 1997: Re: garding kidneystones, placement of pigtail stents, effects on both fetus and mother,

Re: garding kidneystones, placement of pigtail stents, effects on both fetus and mother,

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Tue, 29 Jul 1997 13:21:05 -0500 (CDT)

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In reply to: Barbara: "regarding kidneystones, placement of pigtail stents, effects on both fetus and mother,"

Looking for information regarding kidney >>stones, placement of pigtail stents, effects on both fetus and mother, types
>>of delivery suggested and complications thereof.

While I would not consider myself an "expert" in renal stents, I have cared for a number of women with kidney stones, both with and without stents.

Kidney stones, also called urolithiasis, are no more common in pregnancy than the general population, with an incidence of about 1 in 3000 pregnancies. Although most arise from pure "bad luck," a lesser number are due to increased levels of calcium from hyperparathyroidism. A blood test for levels of calcium and phosphorus can help diagnose this. Symptoms include blood in the urine, flank pain, persistent or recurrent kidney infections (phyelonephritis), and coliky abdominal pain. The diagnosis is by a renal ultrasound (harmless to the baby), or an IVP (intravenous pyelogram), usually done as a "one shot" test in pregnancy to limit radiation exposure to the fetus.

Most stones in pregnancy probably pass without difficulty, since the kidneys and kidney tubes (ureters) are a little swollen during normal pregnancy, probably from the hormone progesterone. The stones simply pass through into the bladder and through the urethra out of the body. In other cases the stones are too large, and in more unusual cases they are so large that they block off the ureter completely, which can lead to severe pain and kidney damage. In such cases a "stent" is placed, which is a thin, long, tubular piece of silastic or similar substance that is either placed through the bladder and up into the ureter or kidney, or through a small puncture in the back and into the kidney (called a percutaneous nephrostomy, which simply means "hole in the kidney through a hole in the skin"!). In both cases the stent is placed to relieve pressure on the kidney to let urine either pass through the bladder, or out the tube in the back, into a bag. A "pigtail" stent has a little curly-Q on the end in the bladder to prevent it from climbing up towards the kidney and getting lost. I assume, then, that your stent is in the bladder.

This should not affect the baby, except to perhaps indirectly help the baby by preventing you from getting renal failure or pyelonephritis, which can cause preterm labor. It also should not affect the route of labor. I would not do a c/section, for instance, just because someone had a stent in place. Vaginal delivery should work just fine and should not be affected in any way by having a stent in place.

I hope this reassures you, and that you have a successful pregnancy.

--
Ashley Hill
D. Ashley Hill, M.D.
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, FL
dahmd@gate.net

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