Special Considerations

J.F. HERMIEU, L. BOCCON-GlBOD

7.1 Introduction 61

7.2 Anatomical and Physiological Modifications During Pregnancy 61

7.3 Diagnostic Procedures in the Pregnant Patient

7.3.1 Doppler Ultrasound 62

7.3.1.1 Evaluating the Dilatation of the Urinary Tract 62

7.3.1.2 The Study of Ureteral Jets 62

7.3.1.3 Vaginal Ultrasound 62

7.3.1.4 Measuring the Resistivity Index 62

7.3.2 Irradiation and Pregnancy 63

7.3.2.1 Risk of Fetal Malformation 63

7.3.2.2 Risk of Radiation-Induced Tumors 63

7.3.2.3 Mutagenic Risk 63

7.3.3 Intravenous Urography 63

7.3.4 Computerized Tomography 63

7.3.5 Retrograde Ureteropyelography 63

7.3.6 Magnetic Resonance Imaging 64

7.4 Treatment 64

7.4.1 Oral Treatment 64

7.4.1.1 Analgesics 64

7.4.1.2 Nonsteroidal Anti-inflammatory Drugs 64

7.4.1.3 Alpha 1 Adrenergic Blockers 64

7.4.1.4 Antibiotic Therapy 64

7.4.1.5 Other Medications 65

7.4.2 Surgical Treatment 65

7.4.2.1 Ureteral Stents 65

7.4.2.2 Percutaneous Nephrostomy 66

7.4.2.3 Ureteroscopy 66

7.4.2.4 Extracorporal Shock-Wave Lithotripsy 66

7.4.2.5 Percutaneous Nephrolithotomy 67

7.4.2.6 Open Surgery 67

7.5 Particular Treatments of Certain Urological Emergencies in Pregnant Women 67

7.5.1 Urinary Tract Calculi 67

7.5.2 Urinary Tract Infections 67

7.5.3 Spontaneous Renal Rupture 69

7.5.4 Placenta Percreta Involving Urinary Bladder 70

7.6 Conclusion 70 References 70

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