Results
Of the patients included in the study, 56.25% (n = 27) were in the
second and 43.75% (n = 21) were in the third trimesters. Of the second
trimester patients, 66.6% were nulliparous (n = 18) and 33.4%
multiparous (n = 9). No first trimester or early second trimester
patient existed. Most were through late second trimester or in the third
trimester. The number of births given by the multiparous was 2.9 ± 0.9
(2-5).
Hydronephrosis was 66.7% and 62% of the pain was observed on the right
side. Of the patients presenting with acute flank pain, 50% (n = 12) of
the nulliparas and 33.3% (n = 8) of the multiparas described colic-like
pain, while the rest described suppressive, blunt or aching pain. There
was no statistically significant difference between the two groups.
In this study, age and gestational week values were found to be
significantly lower in nulliparous pregnant women compared to
multiparous (age 25.1 ± 3.7 - 28.7 ± 3.8 p=0.004 and gestational week
22.9 ± 3.7 - 26.3 ± 4.0 p=0.005 respectively), however VAS score values
turned out to be higher (7.2±1.2 and 5.8±1.9 p=0.004, respectively)
(Table 1). In the total cohort, a significant, medium level, positive
correlation was spotted between hydronephrosis grade and VAS score
values. VAS score values increased as the degree of hydronephrosis
increased in the total cohort (r = 0.349 p = 0.015) (Table 2). When the
two groups were evaluated separately, a medium level, same-direction,
significant correlation was found between hydronephrosis grade and VAS
scores in the nulliparous (Table 3). As the hydronephrosis increased
in the nulliparous, VAS score values also increased. (r = 0.494 p =
0.014). Whereas in multiparas, there was no correlation between the
degree of hydronephrosis and VAS score (r = 0.178 p = 0.405) (Table 3).
To our knowledge this is one of the first studies comparing nulliparous
and multiparous pregnant women.
Comparing the two groups, no statistically significant difference
existed in terms of BM, hydronephrosis grade, hydronephrosis side,
creatinine value, type and side of pain (Table 1). In both groups,
91.7% of the patients (n = 20) benefited from conservative treatment
and 8.7% (n = 4) were placed ureteral JJ stent. Two of the pregnant
women who had ureteral stents were nulliparous and two were multiparous.
One patient with ureteral stent had grade 2 and the other three had
grade 3 hydronephrosis. Ureteral JJ stent was placed on the left side in
one patient and on the right side in 3 patients. All patients with
ureteral JJ stenting described colic pain and had VAS scores of 9 (n =
2) and 10 (n = 2). Ureteral JJ stent placement significantly decreased
the hydronephrosis and the pain. Control US was performed 2 weeks after
JJ stent placement. Patients included in the study were followed up
until 36th-38th gestational weeks in
average. However, obstetric data were not obtained after giving birth.