What causes hydronephrosis in pregnant women?

The types of physical symptoms that pregnant women suffer during pregnancy are very painful for them and their families. Not only are they worried about the health of the pregnant women, but they are also worried that the treatment will affect the physical condition of the fetus. So what should pregnant women do if they have hydronephrosis and fever?

What to do if a pregnant woman has hydronephrosis and fever

First, conservative treatment should be carried out. For patients with mild hydronephrosis and slow disease progression, if the renal function has reached a balanced and stable state, they can continue to be observed and do not need surgical treatment. Only symptomatic treatment can be performed. However, regular maintenance should still be carried out to monitor the progress of water storage. Some infarctions that can be eliminated spontaneously, such as physiological hydronephrosis in pregnant women, do not need to be treated.

Secondly, a partial solution. While carrying out symptomatic treatment, local treatment can be adopted for the lesions at the infarction site, such as adhesion separation, fiber band disconnection, vascular mobilization and reconnection, stone removal, etc. When part of the urethra is compressed for too long and has caused serious damage to the development of the urethra, this section of the urethra should be removed before treatment. When the infarction has caused severe water retention in the kidneys, a fistula drainage method should be performed first.

Finally, surgery was performed. If hydronephrosis worsens idiopathically, clinical manifestations become gradually obvious, renal function continues to decline, and the cause of the infarction has been established and complications exist, surgical treatment should be carried out promptly. Eliminate the obstructive condition that causes hydronephrosis. If it is caused by stones, the stones should be removed. Eliminate compression of chemical fiber bands or aberrant blood vessels. Prostate hyperplasia can be treated by electrocautery or resection. Severe hydronephrosis causes complete loss of function of the affected kidney or severe infection and suppuration, but the other kidney functions well and the affected kidney can be removed.

Should I terminate my pregnancy if I have fetal hydronephrosis?

The normal renal pelvis of a fetus may have slight dilatation, with a dilatation diameter of up to 6 mm. If the renal pelvis is enlarged ≥ 10 mm or there is enlargement of the renal calyces after 30 weeks of gestation, it is hydronephrosis. The main reason for fetal hydronephrosis is obstruction of the junction between the fetal kidney and urethra or obstruction between the urethra and bladder. Hydronephrosis is caused by urethral obstruction, resulting in dilatation of the renal pelvis and calyces accompanied by shrinkage of renal tissue. Urethral obstruction can occur anywhere in the urinary system and can be unilateral or bilateral. The degree of obstruction can be complete or incomplete, and can cause hydronephrosis after a certain period of time. There are two types of hydronephrosis:

One is reversible: the width of the water retention is between 1.01 and 1.63 cm, the renal parenchyma is relatively thick, between 1.02 and 0.58 cm. After the fetus is born, the environment is destroyed and the water retention disappears accordingly. It is often seen in the fetus's bladder filled with urine or the urethra contraction rules are irregular due to some reasons. In addition, the urethra in some cases may have some anatomical abnormalities.

The other type is irreversible: the width of the renal ureter is 2.15-2.56 cm, the thickness of the renal parenchyma is 0.3-0.2 cm, which is more common in congenital ureteral stenosis and has many metabolic changes. It should be treated in time after birth.

In general, it is crucial to fully understand the primary type of fetal hydronephrosis and conduct regular follow-up. If the total width of fetal hydronephrosis is 0.58 cm, it can be considered normal. If the total width of the water reservoir is >2.15 cm or the renal parenchyma thickness is <0.2 cm, it is irreversible and the pregnancy can be terminated visually.