hyd: Pregnant woman with 4-cm kidney stone successfully treated after delivery at AINU
Hyderabad, Aug 26(TNT): A 27-year-old pregnant woman carrying a large kidney stone measuring nearly 4 cm was successfully treated at Asian Institute of Nephrology and Urology (AINU), Hitec City, after doctors opted for close monitoring during pregnancy and deferred definitive treatment until after delivery.
The woman had no significant symptoms during pregnancy. However, urine examinations during the first trimester repeatedly showed pus cells, proteinuria and microscopic blood, while urine cultures detected E. coli, the hospital said in a release here on Wednesday.
An ultrasound performed during the seventh month of pregnancy revealed a large left staghorn kidney stone measuring around 35×18 mm and occupying more than half of the kidney.
Senior Consultant Urologist at AINU Hospital Hitec City Dr Deepak Ragoori said the size and configuration of the stone presented a complex clinical decision, but the patient remained clinically stable.
Considering her condition and stage of pregnancy, the medical team opted for conservative management with close monitoring instead of immediately undertaking definitive stone surgery, he said.
The pregnancy progressed safely and the woman subsequently underwent a Caesarean section, delivering a healthy baby.
Two weeks after delivery, a CT scan showed that the stone measured approximately 4.1×2.7 cm. Given its size and configuration, doctors planned definitive treatment through percutaneous nephrolithotomy (PCNL), a minimally invasive procedure used to remove large kidney stones.
Six weeks after the Caesarean section, she underwent PCNL under general anaesthesia and the procedure was completed uneventfully, the hospital said.
Dr Ragoori said the case highlighted that definitive treatment of kidney stones during pregnancy does not always have to be undertaken immediately, with the timing depending on factors such as symptoms, infection, obstruction, stone size and location, kidney function and the condition of the mother and fetus.
“When a pregnant woman is clinically stable, and there is no emergency indication for intervention, careful monitoring may allow the pregnancy to progress safely, with definitive treatment undertaken after delivery,” he said.
However, kidney stones during pregnancy cannot be ignored as pain, fever, urinary infection, obstruction or deterioration in the mother’s condition could require urgent intervention, he added.
Dr Chalapathi Raju, Dr Vishwajit Reddy, Dr Neelam and Dr L Udaya Kumar participated in the procedure.
The AINU Hitec City team emphasised the importance of close follow-up during pregnancy to identify early signs of infection or other complications and initiate appropriate treatment.
The case demonstrated that in managing kidney stones during pregnancy, choosing the appropriate timing and safest treatment approach can help protect both mother and baby while ensuring definitive treatment is not compromised, the hospital added.
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