Gebelikte Ultrasonografi Kılavuzluğunda Gerçekleştirilen Perkütan Nefrostomi İşlemi Etkin ve Güvenli Midir?: Tek Merkez Deneyimi
Abstract
Amaç: Çalışmanın amacı gebelikte uygulanan ultrason eşliğinde perkütan nefrostomi (PN) yerleştirilmesi işleminin etkinlik ve güvenilirliğini ortaya koymaktır.
Yöntem: Haziran 2020 ile Haziran 2023 tarihleri arasında merkezimizde gebe hastalarda uygulanan PN yerleştirilmesi işlemleri retrospektif olarak taranarak işlem parametreleri, görüntüleme bulguları, teknik başarı, işlem komplikasyonları ve gebelik sonuçları değerlendirilmiştir.
Bulgular: PN yerleştirilmesi uygulanan hastalarda ortalama gebelik yaşı 29,04±7,01 hafta olup 7 ile 36 hafta arasında değişmekteydi. PN endikasyonları sırasıyla taş (%46,2), piyelonefrit (%34,6) ve gebeliğe bağlı taşsız semptomatik hidronefroz (%19,2) idi. 27 işlemden 25'inde (%92,59) PN işlemi başarılı şekilde gerçekleştirilmiş olup major komplikasyon saptanmamıştır. Üç vakada geçici hematüri şeklinde minor komplikasyon saptanmıştır. Kataterin ortalama takılı kalma süresi 72,58 gündür. İşlem yapılan tüm hastalarda semptomatik ve klinik iyileşme sağlanmıştır. PN uygulanan 22 gebede (%84,6) zamanında doğum, 3 gebede (%11,5) erken doğum ve 1 gebede (%3,8) düşük saptanmıştır.
Sonuç: Ultrason eşliğinde PN yerleştirilmesi işlemi gebelikte obstrüktif hidronefroz varlığında yüksek başarı oranı ile uygulanabilen etkin ve güvenilir bir yöntemdir. Bu prosedür, iyonlaştırıcı radyasyonun kullanılmasını önleyerek hem fetusun hem de annenin güvenliğini sağlar.
Keywords
References
- 1. Lindquester WS, Novelli PM, Amesur NB, Warhadpande S, Orons PD. A ten-year, single institution experience with percutaneous nephrostomy during pregnancy. Clin Imaging. 2021;72:42-46. doi: 10.1016/j.clinimag.2020.11.016.
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- 6. Waltzer WC. The urinary tract in pregnancy. J Urol. 1981;125(3):271-276. doi: 10.1016/s0022-5347(17)55008-9.
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- 8. Choi CI, Yu YD, Park DS. Ureteral stent insertion in the management of renal colic during pregnancy. Chonnam Med J. 2016;52(2):123-127. doi: 10.4068/cmj.2016.52.2.123.
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- 11. Van Sonnenberg E, Casola G, Talner LB, Wittich GR, Varney RR, D'Agostino HB. Symptomatic renal obstruction or urosepsis during pregnancy: Treatment by sonographically guided percutaneous nephrostomy. AJR Am J Roentgenol. 1992;158(1):91-94. doi: 10.2214/ajr.158.1.1727366.
- 12. Epelboym Y, Tivnan P, Desai K, O'Horo S. Percutaneous nephrostomy placement in pregnant patients: A retrospective single center experience. J Matern Fetal Neonatal Med. 2022;35(5):970-974. doi: 10.1080/14767058.2020.1740673.
- 13. Şahlı AS, Gençay S, Tayman C. Comparison of early language skills of premature and full-term infants. Türkiye Çocuk Hastalıkları Dergisi. 2021;15(6):501-506.
- 14. Ercil H, Arslan B, Ortoglu F, et al. Conservative/surgical treatment predictors of maternal hydronephrosis: Results of a single-center retrospective non-randomized non-controlled observational study. Int Urol Nephrol. 2017;49(8):1347-1352. doi: 10.1007/s11255-017-1619-6.
- 15. Kapoor SR, Maldow DJ, Baran TM, Sharma AK. Rethinking time-to-exchange: Outcomes of nephrostomy tube placement in pregnancy. J Vasc Interv Radiol. 2021;32(8):1231-1233. doi: 10.1016/j.jvir.2021.04.013.
- 16. Dai JC, Nicholson TM, Chang HC, et al. Nephrolithiasis in pregnancy: Treating for two. Urology. 2021;151:44-53. doi: 10.1016/j.urology.2020.06.097.
- 17. Semins MJ, Matlaga BR. Management of urolithiasis in pregnancy. International Journal of Women's Health. 2013;5:599-604.
- 18. He M, Lin X, Lei M, Xu X, He Z. The identification of pregnant women with renal colic who may need surgical intervention. BMC Urol. 2022;22(1):30. doi: 10.1186/s12894-022-00985-x.
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Is Ultrasound-Guided Percutaneous Nephrostomy Efficacious and Safe in Pregnant Patients?: A Single Center Experience
Abstract
Aim: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrostomy (PCN) placement in pregnancy.
Method: Medical records of 26 pregnant patients who were inserted with a total of 27 PCN catheters between June 2020 to June 2023 were retrospectively analyzed to assess imaging findings, procedural parameters, technical success, delivery outcomes, and procedural complications.
Results: At the time of placement of the PCN, the mean gestational age was 29.04±7.01 weeks (range 7 - 36 weeks). The indications for insertion of the PCN catheter included: 1) obstructing calculi (46.2%), 2) pyelonephritis (34.6%), and 3) symptomatic hydronephrosis without calculi (19.2%). Successful catheter placement was achieved in 25/27 procedures, yielding a success rate of 92.59%, and no major complications. Minor instances of transient hematuria were encountered in three cases. The mean duration of catheter retention was 72.58 days. All patients exhibited significant clinical and symptomatic improvement. Among these patients, 22 patients (84.6%) delivered their babies at full-term, 3 patients (11.5%) delivered prematurely, and 1 patient (3.8%) experienced a miscarriage.
Conclusion: Ultrasound-guided PCN placement is a reliable method with high success and efficacy that can be applied during pregnancy. This procedure avoids the use of ionizing radiation, ensuring safety for both the fetus and the mother.
Keywords
References
- 1. Lindquester WS, Novelli PM, Amesur NB, Warhadpande S, Orons PD. A ten-year, single institution experience with percutaneous nephrostomy during pregnancy. Clin Imaging. 2021;72:42-46. doi: 10.1016/j.clinimag.2020.11.016.
- 2. Venyo AKG, Fatola CO, Adegbite D, Khan AN. Nephrostomy in pregnancy a district general hospital experience over five years. Journal of Biomedical Graphics and Computing. 2014;5(1):1-10. doi: 10.5430/jbgc.v5n1p1.
- 3. Khoo L, Anson K, Patel U. Success and short-term complication rates of percutaneous nephrostomy during pregnancy. J Vasc Interv Radiol. 2004;15(12):1469-1473. doi: 10.1097/01.RVI.0000140639.57131.6D.
- 4. Pabon-Ramos WM, Dariushnia SR, Walker TG, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol. 2016;27(3):410-414. doi: 10.1016/j.jvir.2015.11.045.
- 5. Goldfarb RA, Neerhut GJ, Lederer E. Management of acute hydronephrosis of pregnancy by ureteral stenting: risk of stone formation. J Urol. 1989;141(4):921-922. doi: 10.1016/s0022-5347(17)41053-6.
- 6. Waltzer WC. The urinary tract in pregnancy. J Urol. 1981;125(3):271-276. doi: 10.1016/s0022-5347(17)55008-9.
- 7. Fainaru O, Almog B, Gamzu R, Lessing JB, Kupferminc M. The management of symptomatic hydronephrosis in pregnancy. BJOG. 2002;109(12):1385-1387. doi: 10.1046/j.1471-0528.2002.01545.x.
- 8. Choi CI, Yu YD, Park DS. Ureteral stent insertion in the management of renal colic during pregnancy. Chonnam Med J. 2016;52(2):123-127. doi: 10.4068/cmj.2016.52.2.123.
- 9. Şimşir A, Kızılay F, Semerci B. Comparison of percutaneous nephrostomy and double J stent in symptomatic pregnancy hydronephrosis treatment. Turk J Med Sci. 2018;48(2):405-411. doi: 10.3906/sag-1711-5.
- 10. Kavoussi LR, Albala DM, Basler JW, Apte S, Clayman RV. Percutaneous management of urolithiasis during pregnancy. J Urol. 1992;148(3 Pt 2):1069-1071. doi: 10.1016/s0022-5347(17)36820-9.
- 11. Van Sonnenberg E, Casola G, Talner LB, Wittich GR, Varney RR, D'Agostino HB. Symptomatic renal obstruction or urosepsis during pregnancy: Treatment by sonographically guided percutaneous nephrostomy. AJR Am J Roentgenol. 1992;158(1):91-94. doi: 10.2214/ajr.158.1.1727366.
- 12. Epelboym Y, Tivnan P, Desai K, O'Horo S. Percutaneous nephrostomy placement in pregnant patients: A retrospective single center experience. J Matern Fetal Neonatal Med. 2022;35(5):970-974. doi: 10.1080/14767058.2020.1740673.
- 13. Şahlı AS, Gençay S, Tayman C. Comparison of early language skills of premature and full-term infants. Türkiye Çocuk Hastalıkları Dergisi. 2021;15(6):501-506.
- 14. Ercil H, Arslan B, Ortoglu F, et al. Conservative/surgical treatment predictors of maternal hydronephrosis: Results of a single-center retrospective non-randomized non-controlled observational study. Int Urol Nephrol. 2017;49(8):1347-1352. doi: 10.1007/s11255-017-1619-6.
- 15. Kapoor SR, Maldow DJ, Baran TM, Sharma AK. Rethinking time-to-exchange: Outcomes of nephrostomy tube placement in pregnancy. J Vasc Interv Radiol. 2021;32(8):1231-1233. doi: 10.1016/j.jvir.2021.04.013.
- 16. Dai JC, Nicholson TM, Chang HC, et al. Nephrolithiasis in pregnancy: Treating for two. Urology. 2021;151:44-53. doi: 10.1016/j.urology.2020.06.097.
- 17. Semins MJ, Matlaga BR. Management of urolithiasis in pregnancy. International Journal of Women's Health. 2013;5:599-604.
- 18. He M, Lin X, Lei M, Xu X, He Z. The identification of pregnant women with renal colic who may need surgical intervention. BMC Urol. 2022;22(1):30. doi: 10.1186/s12894-022-00985-x.
- 19. Muslumanoglu AY, Binbay M, Yuruk E, et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309-314. doi: 10.1007/s00240-010-0346-6.
Details
| Primary Language | English |
|---|---|
| Subjects | Radiology and Organ Imaging |
| Journal Section | Articles |
| Authors | |
| Early Pub Date | January 8, 2024 |
| Publication Date | January 5, 2024 |
| Acceptance Date | December 11, 2023 |
| Published in Issue | Year 2023 Issue: 21 |
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