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.