In this episode, Dr. Suzette Sutherland and Dr. Alana Desai from the University of Washington discuss the management of urinary tract stones in pregnant patients, considerations for ureteroscopy, and consequences of radiation exposure in the fetus.

First, the doctors underscore the importance of ultrasound as the first line imaging modality to minimize fetal exposure to radiation. Dr. Sutherland and Dr. Desai also delve into nausea and pain management options, recommended diets for prevention of stone formation during pregnancy, and the necessity of involving a multidisciplinary team in such cases. The episode concludes with a remarkable case study from Dr. Desai’s experience.

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SHOW NOTES

00:00 - Introduction02:06 - Incidence and Risk Factors of Kidney Stones in Pregnancy03:29 - Physiological Changes and Stone Formation in Pregnancy07:04 - Diagnosing Kidney Stones in Pregnancy13:08 - Expectant Management vs. Intervention14:41 - Managing Pain and Nausea in Pregnant Patients with Kidney Stones17:13 - Decompression Methods for Kidney Stones in Pregnancy23:13 - Ureteroscopy as a Preferred Intervention26:05 - Case Description from Dr. Desai30:04 - Considerations for Ureteroscopy in Pregnant Patients31:14 - Preventing Kidney Stones in Pregnancy

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RESOURCES

Lyon, M., Sun, A., Shah, A., Llarena, N., Dempster, C., Sivalingam, S., Calle, J., Gadani, S., Zampini, A., & De, S. (2023). Comparison of Radiation Exposure for Pregnant Patients Requiring Intervention for Suspected Obstructing Nephrolithiasis. Urology, 182, 61–66. https://doi.org/10.1016/j.urology.2023.09.023

Thongprayoon, C., Vaughan, L. E., Chewcharat, A., Kattah, A. G., Enders, F. T., Kumar, R., Lieske, J. C., Pais, V. M., Garovic, V. D., & Rule, A. D. (2021). Risk of Symptomatic Kidney Stones During and After Pregnancy. American journal of kidney diseases : the official journal of the National Kidney Foundation, 78(3), 409–417. https://doi.org/10.1053/j.ajkd.2021.01.008