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Urolithiasis in pregnancy
Last reviewed: 04.07.2025
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Urolithiasis during pregnancy is rare. The risk of developing the disease is higher in pregnant women over 35 years of age. Pregnancy is not the cause of kidney stones, but it is a significant risk factor. During pregnancy, a woman's ureters may expand, causing stones to move more intensively and an attack of severe renal colic to occur. For pregnant women with chronic kidney disease, the prognosis for the course of the underlying disease and the outcome of pregnancy in general is favorable.
Causes urolithiasis in pregnancy
Urolithiasis has a complex of causes, there is no single factor that leads to the formation of stones. The etiology of urolithiasis in pregnant women does not have significant differences. As a rule, the disease manifests itself with the complex effect of several factors on the body:
- metabolic disorders;
- congenital pathologies of the excretory organs leading to impaired urine outflow;
- disorders of the endocrine system;
- changes in urine acidity; normally, the pH should be slightly acidic, but acidity can be disrupted due to dietary factors;
- damage to the excretory organs by bacteria, which can proceed unnoticed and without symptoms until a certain point;
- violation of the nervous regulation of the excretory system;
- gastrointestinal tract dysfunction;
- heat leading to dehydration;
- side effects of some medications;
- hypodynamia.
A common cause that influences the development of urolithiasis in pregnant women is impaired urine flow. This often occurs in the late stages of pregnancy, when the uterus increases significantly in size and presses on the kidneys. Because of this, urine stagnates, and conditions are created for the development of infectious diseases, resulting in pyelonephritis of pregnant women.
Another common cause of kidney stones is high urine concentration, as the pregnant woman's body is prone to swelling due to kidney dysfunction. In this case, the pregnant woman is strongly advised to limit fluid intake as much as possible, which reduces the volume of urine but increases the concentration.
Symptoms urolithiasis in pregnancy
It is important for a woman to be aware of the course and symptoms of urolithiasis during pregnancy. Then it will be possible to learn about the disease earlier and receive timely qualified help. The first sign of an exacerbation of urolithiasis is paroxysmal pain in the lower back, fever, nausea, bloating in the intestinal area, painful urination. When the colic attack passes, the stones can pass with urine on their own. When the attack is over, you may notice that the urine has acquired a reddish color due to damage to the mucous membrane of the urinary tract by stones.
Diagnostics urolithiasis in pregnancy
To diagnose the disease, it is necessary to collect data for the anamnesis:
- describe the strength and duration of pain;
- describe associated symptoms;
- determine the presence of blood in the urine;
- find out whether any surgery was performed on the urinary tract;
- are there any problems with the digestive system;
- presence of the disease in blood relatives;
- what medications does the patient take;
- Have there been any previous bone fractures?
Laboratory tests and instrumental diagnostic methods are used for diagnostics.
Ultrasound is recognized as the safest and most informative examination. X-ray examination plays an important role in making a diagnosis. Excretory urography allows you to obtain information about the condition of the kidneys and the location of the stone, and will help to get an idea of the functioning of the kidneys. In exceptional cases, when it is impossible to make a final diagnosis based on the results of these examinations, retrograde ureteropyelography is used.
Computed tomography is practically not used, since X-ray irradiation is contraindicated for pregnant women.
Laboratory tests will determine the chemical composition of the stone and detect metabolic disorders that provoked its formation. A blood test will be able to detect non-specific inflammatory changes (increased ESR, left shift in the leukocyte formula, increased C-reactive protein). To get a complete picture, the doctor may prescribe a test to determine the level of urea, creatinine, calcium, protein, urine density, and the presence of bacteria in the blood.
The results of the research will determine the treatment tactics.
Differential diagnosis
For differential diagnosis, to distinguish urolithiasis from appendicitis, ureteral tumor, pyelonephritis or glomerulonephritis, retrograde endoscopic ureteropyeloscopy is used.
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Treatment urolithiasis in pregnancy
Treatment of the disease between exacerbations consists of combating the inflammatory process, destruction and subsequent removal of stones. For this purpose, traditional treatment with herbs and mineral waters is used. Folk recipes will help reduce the recovery time.
Medicinal treatment of urolithiasis during pregnancy aims to relieve spasms, destroy and remove stones, and eliminate inflammation. Treatment takes a long time, requires regular intake of herbal medicines, herbs, mineral water, and medications that relieve pain and spasms.
Medicines for the treatment of urolithiasis
Plants have been used to combat urolithiasis for a long time. Then pharmacists developed combination drugs based on plant extracts.
- Cystone. It is produced in the form of tablets and consists of herbal extracts. The drug is valuable because it is able to destroy stones, while helping to relieve inflammation and spasms. The diuretic effect of Cystone helps to cleanse the kidneys. To remove stones, it is prescribed in a dosage of 2 tablets three times a day. The course of therapy is 3-4 months. It does not cause side effects, its use is safe for urolithiasis during pregnancy.
- Cystenal. Used for prevention, as well as during the acute phase of the disease. Contains extracts of the root of dyeing mirena, essential oils, olive oil. Has an antispasmodic effect. If you increase your fluid intake during the period of taking the drug, this will help facilitate the removal of stones. Prescribed in a dosage of 3-5 drops 3 times a day half an hour before meals. Drops can be diluted with water.
- Canephron. A combination drug based on medicinal herbs, promotes the removal of salts and minor stones, eliminates inflammation. Available in the form of drops and dragees. Prescribed in a dosage of 2 dragees (or 50 drops) 3 times a day.
- Phytolysin. Made from cinquefoil and wheatgrass root extracts, and also contains other medicinal herbs. Phytolysin helps remove stones and crystallized salts, and is used as a preventive measure to help prevent the formation of stones. The drug has not been tested for safety during pregnancy. However, the practice of using the drug confirms the absence of negative effects on the fetus. Phytolysin prevents the proliferation of bacteria that have entered the urinary tract.
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Physiotherapy treatment
Physiotherapeutic treatment of urolithiasis includes:
Use of sinusoidal modulated currents; Dynamic amplipulse therapy; Ultrasound treatment; Laser therapy; Inductothermy.
During exacerbations of urolithiasis during pregnancy, it is recommended to refrain from physiotherapy.
Homeopathic treatment
Treatment of urolithiasis with homeopathic preparations must be combined with a specialized diet, which requires abstaining from eating foods that are rich in purines (coffee, herring, sorrel). Sometimes it is necessary to limit the consumption of dairy products.
In our homeopathic pharmacies, the most frequently recommended "complexons" are from the German manufacturer "Heel".
Renel - will help with kidney stones, inflammation of the urinary tract, effective as part of complex therapy for renal colic, morning pain in the kidney area. Renel is available exclusively in tablet form. Dosage: 1 tablet 3 times a day. The duration of therapy is determined by the attending obstetrician-gynecologist together with the urologist. For the treatment of urolithiasis during pregnancy, it is used only after a preliminary consultation with a specialist.
Berberis-Homaccord - used to eliminate inflammatory processes, spasms in the genitourinary tract, bile ducts, gallstones. Effective if the patient periodically experiences renal colic. Offered in the form of drops and ampoules. Berberis-Homaccord is often used as an auxiliary drug for chronic forms, excessive load on the immune system, and the consequences of allopathy treatment. Dosage: 10 drops 3 times a day. The duration of treatment is determined by the doctor. The drug is not recommended for use in early pregnancy.
Populus compositum is used for effective urine drainage and detoxification in case of urinary system dysfunction, kidney dysfunction. It relieves inflammation and swelling, eliminates spasms. Populus compositum is taken 10 drops 3 times a day. On average, the duration of treatment is from one to three months. During pregnancy, the drug can be used after consultation with a doctor.
Solidago compositum C is used in complex treatment during exacerbation, as well as in chronic diseases of the kidneys and urinary tract. It is offered only in the form of ampoules for injections. It relieves inflammation, eliminates pain and spasms, effectively fights microbes. Dosage for treatment: 1 injection 1-3 times a week.
Herbal treatment
The use of medicinal herbs enhances the effect of treatment. There are many recipes. For example, 1 teaspoon of horsetail herb, 1 teaspoon of tansy flowers, 2 teaspoons of lingonberry leaves are poured with 1 liter of boiling water and boiled for several minutes. Then the composition is drunk 200 grams half an hour before meals in the morning and evening. The decoction has a good diuretic effect and helps fight inflammation.
An infusion of bearberry leaves, hernia grass, knotweed and corn silk will help eliminate pain and relieve inflammation. To prepare the infusion, take the ingredients in equal proportions. Drink 50 grams of the infusion 3 times a day.
A mixture of equal parts of honey, vodka, radish and beet juice will help remove stones. The ingredients must be thoroughly mixed and left to infuse in a dark place for 3-4 days. The composition is taken 1 tablespoon diluted in a glass of hot water. The course will require 1 liter of tincture.
How can fruits and berries help?
Traditional medicine suggests using both medicinal herbs and ordinary berries, fruits and vegetables.
- Watermelon has a diuretic effect, helps to wash out stones. However, to achieve the effect, it is necessary to consume at least 2 kg daily.
- Regular white cabbage prevents urinary stagnation.
- Cranberries help eliminate urine and fight bacteria.
- Cranberry juice has the same effect.
- Strawberries prevent urinary stagnation.
- Dill helps remove excess fluid and salts.
- Pear, barberry, gooseberry and melon have a noticeable diuretic effect.
Surgical treatment
There are cases when pregnant women need surgery to remove kidney stones. But this method of combating urolithiasis is used only in extreme cases, since any intervention is more difficult to bear during this period, and its consequences and complications can negatively affect the health of the baby. The best solution for urolithiasis is surgery and sanitation of the urinary tract before conception.
Surgical intervention is required in 20-30% of pregnancies complicated by urolithiasis.
Indications for surgical intervention for urolithiasis during pregnancy:
- Ureteral obstruction with increasing azotemia.
- The presence of stones in one kidney.
- Intractable pain despite conservative measures.
- Urosepsis.
- Renal colic threatening premature birth.
Prevention
Correcting metabolic disorders and eliminating factors that cause stone formation will help to cope with the formation of new stones and prevent exacerbation of urolithiasis during pregnancy: activating blood circulation in the kidneys, drinking enough fluids, eliminating infections, diet, taking vitamins, and physiotherapy.