Evaluation of treatment results for pregnant women with acute renal colic referred to Emergency unit of Shahid Faghihi Hospital in Shiraz University of Medical Sciences (2015 to 2020) - A Retrospective Study

Background and aim: Renal colic is one of the common causes of abdominal pain in pregnant women. We evaluated the outcome of renal colic during pregnancy in our referral center.  Methods: Between March 2015 to March 2020, a total of 228 pregnant patients were referred to the emergency unit with renal colic. Most of them managed conservatively, but some of them were complicated and need more procedures. Results: Of 228 patients, 179 patients had only microscopic hematuria and mild hydronephrosis with small or no stone in ultrasonography. They responded to conservative management and discharged. 26 patients had ureteral stone smaller than 6 mm that were passed with medical therapy. 11 patients were in third trimester with ureteral stone and/or renal stone which percutaneous nephrostomy applied. 12 patients had large distal ureteric stone underwent ureteroscopy and stent insertion. 24 patients that were in the first or second trimester had internal stent (15 patients) or nephrostomy (9 patients) until delivery of their fetus. 3 patients in second trimester did not tolerate/accept or complicated stent or nephrostomy, so that they had intractable colic. After explaining all the possible complications and obtaining the written informed consent, scheduled for urgent percutaneous nephrolithotomy with ultrasonographic guidance in flank position. Conclusion: Renal colic in pregnancy is common and mostly managed conservatively, but in some cases may need nephrostomy tube insertion, ureteroscopy and stent insertion. ESWL is contraindicated and PCNL is not recommended as the first opinion in pregnancy, unless in urgent situation.