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Urolithiasis in Pregnancy: Current Diagnosis, Treatment, and Pregnancy Complications

Cormier, Clint M. MD*; Canzoneri, Bernard J. MD; Lewis, David F. MD; Briery, Christian MD§; Knoepp, Leise MD; Mailhes, John B. PhD

Obstetrical & Gynecological Survey: November 2006 - Volume 61 - Issue 11 - p 733-741
doi: 10.1097/01.ogx.0000243773.05916.7a
CME Program: CATEGORY 1 CME REVIEW ARTICLES 31, 32, AND 33: CME REVIEW ARTICLE 32
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CME

Urolithiasis complicates up to one in every 200 pregnancies; consequently, the practicing obstetrician should be aware of the symptoms of urolithiasis, the diagnostic procedures available for its diagnosis, and their associated risks. These include ultrasound, urography, and magnetic resonance imaging. Diagnosis of urolithiasis during pregnancy can be a challenge as a result of the normal physiological changes of pregnancy. Conservative management is the first-line treatment for noncomplicated urolithiasis in pregnancy. If spontaneous passage of the stone does not occur or if complications develop, urologic consultation should be obtained. Several obstetric complications have been associated with urolithiasis, including preterm labor and preterm premature rupture of membranes, although the reported rates of these complications in association with urolithiasis vary widely and overlap normal background rates. Given that urolithiasis will be encountered by most obstetricians, and that obstetricians are often on the front line of management for this condition, an appreciation of current diagnostic modalities, treatment protocols, and associated potential obstetric complications is warranted.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to recall that urolithiasis is common in pregnancy, state that there are a variety of diagnostic procedures, summarize that conservative treatment is usually successful, and explain that complications of pregnancy usually occur when there is failure of conservative treatment.

*Clinical Instructor, †Assistant Professor, ‡Professor and Chairman, ¶Resident, and ∥Professor, Louisiana State University Health Sciences Center, Shreveport, Louisiana; and §Assistant Professor, University of Mississippi Medical Center, Jackson, Mississippi

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2006. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

Lippincott Continuing Medical Education Institute, Inc. has identified and resolved all faculty conflicts of interest regarding this educational activity.

Reprint requests to: David F. Lewis, MD, Professor and Chairman, Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, P.O. Box 33932, Shreveport, LA 71130-3932. E-mail: DLewi1@Lsuhsc.edu.

© 2006 Lippincott Williams & Wilkins, Inc.