Managing Kidney Stones during Pregnancy

  • Jan 03, 2019
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Preventing kidney stones is essential to avoid
complications during delivery or damage to the foetus.

In any condition, kidney stones can be a pain in more ways than one. But having a kidney stone during pregnancy can be a double whammy since the regular problems of child-bearing are compounded. It is important to clarify, however, that pregnant women are not more prone to developing kidney stones. The issue is simply that diagnosing and treating a woman with a kidney stone is more difficult due to the chances of the foetus being harmed. By itself, though, kidney stones are not harmful for the developing baby.

Kidney stones are hard deposits or crystals of minerals and salt that form in the kidneys. These can then move to other parts of the urinary tract. Such stones can vary in size. A small one can pass through the bladder without any problem or pain. But a medium-sized or large stone could lodge along the ureter, leading to severe pain or even bleeding, requiring medical attention.

Causes and Symptoms

Generally, dehydration is a prime cause in kidney stone formation. In a dehydrated body, fluids pass slowly via the kidneys, raising the risks of salts and minerals colliding and binding to each other. Kidney stones are also formed if the urine contains high amounts of calcium, oxalate, phosphate, uric acid and other trace elements. Foods rich in oxalate (beetroot, spinach, chocolate, most nuts and tea) and phosphate (colas) also contribute to stones and should be avoided or consumed minimally.

People with a family history of stones, recurring urinary tract infections, urinary tract blockage (which may occur during pregnancy due to the pressure of the baby on the kidneys), digestive issues, those consuming more colas than water and even women with type 2 diabetes can be more prone to kidney stones.

The symptoms of stones can include pain while urinating, blood in the urine, cloudy or smelly urine, intense pain in the back, lower abdomen or side and accompanying nausea and vomiting. Other tell-tale signs comprise the urge to urinate frequently, passing only small amounts each time as well as fever and chills (indicating infection). Complications from kidney stones during pregnancy may include preterm delivery, gestational diabetes, preeclampsia and other hypertensive issues.

An analysis of blood and urine can determine the presence of kidney stones during pregnancy. Urine tests can detect the presence of blood, calcium crystals or uric acid. CT scans and X-rays are, however, not advisable during pregnancy due to the risk of foetal damage from radiation.

Treatment and Prevention

Typically, treatment depends on their size. While small stones may pass out on their own, daily hydration and medications can also be used to expel stones. In the case of large stones, these can be extracted through surgery. Whereas sound wave lithotripsy is used in the case of normal women to break up stones, it cannot be done during pregnancy as this may harm the baby.

Medications can be administered to control the pain while surgery is done under anaesthesia, ensuring the mother and unborn baby are unhurt during the procedure.

While preparing for pregnancy, all preventive measures must be taken against kidney stones:

Drinking water: Drink 8-10 glasses of water and other liquids daily. Remember, the body requires more water during pregnancy.

Decreasing salt intake: Limit salt intake. Avoid processed, packaged and junk foods high in sodium.

Reducing animal protein: Amino acids and trace elements in protein can promote stone formation.

Limiting calcium consumption: Although calcium supplements are recommended in pregnancy, women with kidney stones need to be watchful, minimising intake.

Despite precautions, if a woman displays the following symptoms, call a doctor immediately:

  • Pain in the back, abdomen or side not controlled by painkillers.
  • Bright-red blood in the urine.
  • Nausea and vomiting that is unresponsive to medication.
  • Watery discharge or vaginal bleeding.
  • Cramps or painful contractions lasting more than four hours.
  • Decreased or minimal foetal movement.
  • Temperature exceeding 100-degree Fahrenheit.

Although kidney stones are not fatal per se, they can lead to kidney infection. In turn, this can cause sepsis. Septic shock or sepsis can arise from any infection in the body, including influenza, pneumonia or urinary tract infections. Globally, sepsis results in almost 33% fatalities.

Moreover, in the third trimester of pregnancy, kidney stones could induce labour pain. Therefore, it is best to take all precautions in avoiding unwanted complications from kidney stones during pregnancy.

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