Discussion Of Ureteral Calculi In Pregnancy

Objective: To discuss the clinical features and diagnosis and treatment of ureteral calculi in pregnancy.Methods: Through consulting the electronic medical records of pregnant women admitted to our hospital from December 2015 to January 2010,a total of 17780 cases of pregnant women were collected,including 15280 cases of natural pregnancy,whose average age was(25±4)years,and 2500 cases assisted reproductive,whose average age was(32±5)years.We evaluated the use rate of pre pregnancy urinary ultrasound and the incidence of ureteral calculi in pregnancy,and compared the difference between the women in the natural pregnancy group and the assisted reproductive group.The observation of the age,educational level,pregnancy,urinary tract infection,clinical symptoms,auxiliary examinations and treatment methods of pregnant women with ureteral calculi were recorded.The relationship between ureteral calculi in pregnancy and age,culture and onset time was analyzed.The clinical characteristics and treatment measures of ureteral calculi in pregnancy were summarized,and the treatment and prognosis were observed.The effect of different treatment modalities on the clinical symptoms of ureteral calculi during pregnancy was compared.Results:All the patients in the auxiliary reproductive group underwent the ultrasonic examination before pregnancy,but the natural pregnancy group did not.The incidence of ureteral calculi in pregnancy respectively was 0.08%(2/2500)and 0.35%(53/15280).Two groups of pre pregnancy urinary ultrasound application rate and the incidence of ureteral calculi in pregnancy were significantly different(P<0.05).In the natural pregnancy group,the incidence of ureteral calculi increases with age decreasing during the age of <26years old,and the incidence of the disease increases with age increaseing during the age of >35 years old.There were differences in the incidence of ureteral calculi in different gestation periods,with the highest incidence at 18~28 weeks,accounting for 76%(40/53).The proportion of ureteral calculi in pregnant women with different educational levels is different,and the educational level of senior high school students is relatively high,accounting for 67%(36/53).Urinary tract infection accounted for 89.09%(49/55),34.54%(19/55)were complicated with acute pyelonephritis,3.63%(2/55)infection was more severe,and septic shock occurred.There was a significant difference between the non operation group and the operation group in the clinical symptom control and recurrence rate(P<0.05).The curative effect of the non-surgical group is lower than that of the operation group.The main mode of operation was ureteral stent implantation under local anesthesia,accounting for about 68.42%(13/19).Conclusion:The overall incidence of ureteral calculi during pregnancy was low,but it has great influence on the mother and fetus.Pre pregnancy urinary tract ultra sound screening is helpful to reduce the incidence of ureteral calculi in pregnancy.T he incidence of ureteral calculi in pregnancy is relatively high in pregnant womenu nder 26 and over 35 years of age.The onset time is more concentrated in the seco nd trimester of pregnancy.Most merge with urinary tract infection.The effect of no n-surgical treatment is poor.Ureteral stent implantation under local anesthesia can e ffectively control symptoms.It has the advantages of simple operation,small impact on maternal,are relatively easy to acceptable to the patient.