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BackTable / OBGYN / Podcast / Episode #43
Urolithiasis in Pregnancy: Balancing Risks & Management
with Dr. Alana Desai
In this episode, Dr. Suzette Sutherland and Dr. Alana Desai from the University of Washington discuss the management of urinary tract stones in pregnant patients, considerations for ureteroscopy, and consequences of radiation exposure in the fetus.
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BackTable, LLC (Producer). (2024, January 10). Ep. 43 – Urolithiasis in Pregnancy: Balancing Risks & Management [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Alana Desai
Dr. Alana Desai is an associate professor with UW Medicine in St. Louis, Missouri.
Dr. Suzette Sutherland
Dr. Suzette Sutherland is the director of female urology with UW Medicine in Seattle, Washington.
Synopsis
First, the doctors underscore the importance of ultrasound as the first line imaging modality to minimize fetal exposure to radiation. Dr. Sutherland and Dr. Desai also delve into nausea and pain management options, recommended diets for prevention of stone formation during pregnancy, and the necessity of involving a multidisciplinary team in such cases. The episode concludes with a remarkable case study from Dr. Desai’s experience.
Timestamps
00:00 - Introduction
02:06 - Incidence and Risk Factors of Kidney Stones in Pregnancy
03:29 - Physiological Changes and Stone Formation in Pregnancy
07:04 - Diagnosing Kidney Stones in Pregnancy
13:08 - Expectant Management vs. Intervention
14:41 - Managing Pain and Nausea in Pregnant Patients with Kidney Stones
17:13 - Decompression Methods for Kidney Stones in Pregnancy
23:13 - Ureteroscopy as a Preferred Intervention
26:05 - Case Description from Dr. Desai
30:04 - Considerations for Ureteroscopy in Pregnant Patients
31:14 - Preventing Kidney Stones in Pregnancy
Resources
Lyon, M., Sun, A., Shah, A., Llarena, N., Dempster, C., Sivalingam, S., Calle, J., Gadani, S., Zampini, A., & De, S. (2023). Comparison of Radiation Exposure for Pregnant Patients Requiring Intervention for Suspected Obstructing Nephrolithiasis. Urology, 182, 61–66. https://doi.org/10.1016/j.urology.2023.09.023
Thongprayoon, C., Vaughan, L. E., Chewcharat, A., Kattah, A. G., Enders, F. T., Kumar, R., Lieske, J. C., Pais, V. M., Garovic, V. D., & Rule, A. D. (2021). Risk of Symptomatic Kidney Stones During and After Pregnancy. American journal of kidney diseases : the official journal of the National Kidney Foundation, 78(3), 409–417. https://doi.org/10.1053/j.ajkd.2021.01.008
Transcript Preview
Typically, again, you start with your basic history. Sometimes they'll tell you, I had an acute, sudden episode of pain in my back, and then it wrapped around to my abdomen, went to my groin. A little while later, I felt like I had to go to the bathroom. It just sounds like a classic stone history. That is very important. I think it's important to evaluate pregnant patients as you would a non-pregnant patient, taking those key events that happened during stone passage, and then, of course, considering the fact that there is a fetus involved. If there is fetal distress, then you have to take that into consideration. Initially, when you evaluate, it is much like a non-pregnant patient in taking that good history in laboratory evaluation as we normally would.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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