Document Detail


Managing severe loin pain in pregnancy.
MedLine Citation:
PMID:  12269677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether the intravenous urogram used in an appropriate setting is a valuable investigation for managing severe loin pain in pregnancy. DESIGN: Prospective observational study. SETTING: University teaching hospital. POPULATION: Fifteen pregnant women referred with severe loin pain. METHODS: A prospective study collecting data over a 24-month period was performed. Women with severe loin pain believed to be of renal origin that had failed to respond to conservative treatment were referred by their obstetricians. The intravenous urogram was performed that consisted of a two-film series (plain film and a 20-minute postmicturition film). MAIN OUTCOME MEASURES: Management of severe loin pain in pregnancy based on the findings of the intravenous urogram. RESULTS: Over the two-year period, 15 women had an intravenous urogram performed at a median gestation of 32 weeks (24-36 weeks). All women had undergone a prior urinary tract ultrasound examination within 24 hours of referral, which showed dilatation on the symptomatic side in 15/15 cases. The intravenous urogram confirmed dilatation on the ipsilateral side in 14/15 cases and revealed the level of dilatation in all of these cases. Delayed excretion of contrast was seen in all 14/15 cases. Three patients had obstructing ureteric calculi revealed by the intravenous urogram and one patient had a non-dilated and non-obstructed system. CONCLUSIONS: An intravenous urogram is a safe investigation in the appropriate setting. It allows for an accurate diagnosis to be made and for appropriate treatment to be instigated with joint decisions from urologic, obstetric and radiologic teams. This multidisciplinary approach care can be specifically tailored to the individual patient, which we feel is safer for both mother and baby.
Authors:
Stuart O Irving; Neil A Burgess
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  109     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-24     Completed Date:  2002-10-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  1025-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Urology, Norfolk and Norwich University Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Dilatation, Pathologic / ultrasonography
Female
Humans
Pain / etiology,  therapy*
Pregnancy
Pregnancy Complications / therapy*,  ultrasonography
Prospective Studies
Ureteral Calculi / complications,  therapy,  ultrasonography
Ureteral Obstruction / etiology,  therapy,  ultrasonography

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