Ureterolithiasis in Pregnancy

A 30-year-old primigravida in the 16th week of pregnancy shows up with right hypogastric pain, pain at the end of micturition and right flank pain.

Urinalysis showed erythrocytes.

The abdominal ultrasound examination began with an intact pregnancy and a mild maternal hydronephrosis on the right side. The transvaginal sonography showed a distal ureteral calculus with dilatation of the right distal ureter.

Small clip of the ureteric stone in ultrasound. Red: ureter. Blue: bladder.
Ureterolithiasis in pregnancy 3d
3D Imaging of the bladder base. Top left: transverse image. Top right: sagittal image. Bottom left: frontal image. Bottom right: 3d reconstruction of the bladder base where both ureters can be clearly seen as well as the stone inside the right ureter.

The stone only measured 3.4mm and after conservative treatment (analgetics and hydration) the patient managed to pass it.

In conclusion, transvaginal sonography provides a perfect way to evaulate distal ureteral calculi and completely avoid radiation, especially in pregnancy.

Bibliography

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