Gebeliğe Bağlı Hidronefrozun Değerlendirilmesi? Üreteral J Stent Erken Doğumu Tetikler Mi?

Amaç: Çalışmanın amacı, yan ağrısı ve hidronefrozu olan gebe kadınlarda tedavi yöntemlerini değerlendirmek ve tedavinin erken doğum eylemine etkisini incelemektir. Gereç ve Yöntemler: Nisan 2014 ve Ocak 2020 tarihleri arasında hastanemize başvuran ve yan ağrısı olan gebe kadınları retrospektif olarak değerlendirdik. Hidronefrozu olan ve Üroloji kliniğine başvuran toplam 54 hasta çalışmaya dahil edildi. Klinik, radyolojik ve laboratuvar bulguları kaydedildi. Hastalar cerrahi girişim yapılanlar Grup 1 olarak ,konservatif tedavi uygulananlar Grup 2 olarak sınıflandırıldı. İki grup arasında hastaneye yatış haftaları, hastanede kalış süreleri ve doğumun gerçekleşme haftası karşılaştırıldı. Bulgular: Çalışmaya 54 hasta dahil edildi. 22 hastaya (40.7%) cerrahi işlem uygulandı (grup 1), 32 (59. 2%) hastaya ise konservatif tedavi uygulanarak taburcu edildi (Grup 2). Cerrahi sonrası alt üriner sistem enfeksiyonu 1 (4.5%) hastada gözlenirken 3 (13.6%) hastada transfüzyon gereksinimi olmayan hematüri gözlendi. Hastaneye yatış süreleri (p:0.43) ve doğum haftaları (p: 0.09) açısından istatiksel olarak anlamlı fark gözlenmedi. Hastanede kalış süreleri arasında ise fark mevcuttu (p<0.05). Taburculuk sonrası üreteral stente bağlı doğuma kadar komplikasyon gözlenmedi ve doğum sırasında DJ stentler çekildi. Sonuç: Gebelik hidronefrozunda yapılacak cerrahi girişimin erken doğumu tetiklediği ve gebeliğe zarar vereceği düşünülür. Ancak cerrahi işlem uyguladığımız hastalarda anne ve bebek için majör bir komplikasyona rastlamadık ve tüm bebeklerin normal zamanda doğduğunu tespit ettik. Aksine gebelikte geçmeyen ağrı ya da altta yatan bir nedenden dolayı oluşan hidronefrozda cerrahiden kaçınmak bebek ve anne için ölüm dahil ciddi riskler oluşturabilir.

Anahtar Kelimeler:

hidronefroz, gebelik, üreteral stent

Evaluation of Pregnancy Hydronephrosis? Does Ureteral J Stent Effect Preterm Birth?

Objective: This study aimed to evaluate the treatment modalities in pregnant women with side pain and hydronephrosis and to examine the effect of treatment on preterm labor.Material and Methods: There cords of pregnant women with flank pain who presented between April 2014 and January 2020 were retrospectively reviewed. The evaluation was made of 54 patients treated in the Urology Clinic for hydronephrosis and side pain treated. Clinical, radiological, and laboratory findings, surgical interventions, and any complications were all recorded and evaluated. Classified the patients undergoing surgical procedures as group 1, and those followed by conservative treatment as group 2. Length of hospital stay, hospital arrival weeks, and birth weeks of the groups were compared.Results: 54 pregnant women included in the study, 22 patients (40.7%) required surgical intervention (Group1), and 32 patients (59.2%) applied conservative management (Group2). Postoperatively, lower urinary tract infection was observed in 1(4.5%) patient, hematuria without transfusion was required in 3(13.6%) patients. Hospital arrival weeks (p:0.43) and birth weeks (p:0.09) of the groups were compared and no significant statistically. But the length of hospital stay (p<0.05) was significantly different. No complications were observed until delivery due to ureteral stent after discharge, and DJ stents were removed from birth.Conclusion: Although it is thought that surgical intervention in pregnancy hydronephrosis will harm preterm birth and pregnancy, there was no major complication of intervention to mother and infant in the study. If neglected, many complications may occur including the death of the mother and the infant.

Keywords:

hydronephrosis, pregnancy, ureteralstent,

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