Assessment of Incidence of Hydroureteronephrosis among Pregnant Women of a Tertiary Care Hospital

Background: Some degree of dilatation of the upper two-thirds of the ureter and the pelvicalyceal system is observed in physiological hydroureteronephrosis. It may be present in 90% of pregnancies and is more pronounced on the right side. It develops as early as 6-10 weeks of gestation and disappears a few weeks after birth. Smooth muscle-relaxant effects of progesterone and mechanical compression have been postulated as contributing factors. Ultrasound is the imaging modality of choice. Most of the cases resolve with conservative measures.

Objectives: The study aimed to assess the incidence of hydroureteronephrosis in pregnancy using ultrasound, to assess the laterality of hydroureteronephrosis in pregnancy and to assess the proportion of subjects with hydroureteronephrosis in pregnancy requiring intervention.

Materials and Methodology: A prospective study was conducted among the pregnant women presenting to the department of obstetrics and gynecology in a tertiary health care hospital from January 2021 to April 2021. A simple random sampling technique was employed, 40 subjects were identified for the study. The relationship between hydroureteronephrosis and gestational age, urinary tract problems and parity were compared.

Results: Unilateral right-sided hydroureteronephrosis was present in 7 (36.8%) of the study subjects with hydroureteronephrosis. Hydroureteronephrosis was observed in 22.5% and 15% of the study subjects on the right and left side respectively during the second trimester. Hydroureteronephrosis was observed in 30% and 15% of the study subjects with urinary tract problems on the right and left side respectively. Hydroureteronephrosis was observed in 13 (52%) of the study subjects with no previous delivery.

Conclusion: The incidence of hydroureteronephrosis was found to be 47.5%. Differentiation of physiological and pathological hydroureteronephrosis is necessary. A coordinated approach between obstetricians and urologists is essential to provide the best care for the mother and the fetus.