Pregnancy is a beautiful journey—until your kidneys decide to throw a surprise party with some uninvited guests: kidney stones. Thanks to a mix of hormonal roller coasters, calcium on the loose, and hydration struggles, these troublemakers find the perfect setup to crash the party.
To make matters worse, an ever-expanding uterus slows things down in the urinary department. Diagnosing and treating them is tricky, given the limited imaging options and pregnancy-safe treatments. So, if you’re expecting, staying hydrated and making mindful dietary choices could help keep these pesky pebbles at bay! But wait, read on to find out what the experts have say.
Some physiological changes during pregnancy, Dr. Shweta Mendiratta, Associate Director-Obstetrics and Gynaecology, Marengo Asia Hospital, Faridabad, says, may lead to increased chances of developing kidney stones: increased calcium excretion in the urine, hormonal variation, and decreased fluid intake due to nausea. She adds that the expanded uterus compresses the urinary system, which leads to urine stasis and further allows for deposits to happen.
Dr. Mendiratta explains that kidney stones can imprison significant discomfort for prenatal women. Usually associated with severe back and/or abdominal pain, haematuria (blood in urine), or urinary tract infections, it really poses a challenge toward proper diagnosis. “Imaging options are limited, so scans are by preference ultrasound as the only safe diagnostic imaging, while MDCT use is avoided to prevent irradiating the foetus in the first trimester,” she says.
Regarding treatment, Dr. Mendiratta says it would primarily include symptom control and care of the mother and foetus. Hydration is recommended if the stones are small, allowing them to pass. She explains that pain management consists of pregnancy-safe medications such as acetaminophen.
If stones end up blocking the urinary tract or if recurrent infections arise, she explains that ureteral stenting procedures may be necessary. As a preventative measure, she advises maintaining adequate hydration, balanced dietary habits, and avoiding excessive calcium supplementation without prior medical advice.
Challenges and Precautions During Pregnancy Against Kidney Stones
Dr. Bhanu Mishra, Consultant Nephrologist at BLK Max Super Speciality Hospital, explains that hormonal changes play a role in kidney stone formation during pregnancy. He states that increased levels of progesterone reduce the motility of the urinary tract, allowing stagnation of urine and increasing the chances of stone formation.
Dr. Mishra further explains that calcium metabolism changes during pregnancy, leading to increased calcium absorption. He states that this, in turn, results in elevated urinary calcium levels, which can contribute to kidney stone formation.
On the issue of dehydration, he says that many pregnant women experience nausea and vomiting, which reduces their fluid intake. He warns that inadequate hydration concentrates the urine, favouring crystallisation and increasing the risk of kidney stones.
The expert also points out that dietary changes during pregnancy can contribute to kidney stone formation. He states that pregnancy cravings may lead to higher consumption of oxalate-rich foods such as spinach, nuts, and chocolate, or a high sodium intake, both of which can increase stone risk.
Discussing diagnostic limitations, Dr. Mishra explains that imaging techniques such as CT scans are generally avoided during pregnancy due to radiation risks. This, he says, makes it particularly challenging to diagnose kidney stones in pregnant women.
Regarding treatment limitations, Dr. Mishra states that many common treatment approaches, including certain pain medications and shock wave lithotripsy, are unsafe during pregnancy. He explains that these restrictions significantly limit the medical interventions available for kidney stone management.
Precautions:
- Dr. Mishra advises staying hydrated by drinking between 2.5 and 3 litres of water daily to minimise urine concentration.
- He recommends a balanced diet with adequate calcium intake from food sources while avoiding excess sodium and oxalate-rich foods.
- Dr. Mishra suggests regular urine testing to detect early stone formation or infections.
- For pain management, he states that only pregnancy-safe analgesics, such as acetaminophen, should be taken if needed.
- He highlights that moderate physical activity can support kidney function and prevent urine stasis.
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