Material and methods
This study was carried out in Iğdır State Hospital between the dates of
October 2018 and February 2019.
During this time, 237 pregnant
women applied to the hospital. In these patients, there were 93 pregnant
women accompanied by pain. Among these 93 pregnant women, 48 patients
who met the criteria were included in the study. The study consisted of
2 groups and a total of 48 patients consisting of Group 1 nulliparous (n
= 24) and Group 2 multiparous (n = 24) pregnant women. Patients admitted
to ER, gynecology and urology wards with acute flank pain were included
in the study.
Written informed consent was obtained from patients’ and their spouses
prior to the study. The consent explained that no additional
intervention was performed other than routine protocols and treatments,
and only the requisite findings would be used in the study. Urinalysis,
urine culture, serum creatinine values were obtained from all patients
and the described character of pain and demographic data were recorded.
All patients had urinary US by the same radiologist.
To assess the degree of
hydronephrosis, maximal anterior–posterior diameter of the renal pelvis
was measured by ultrasound. Visual analogue scale with numerical
evaluation was obtained from all patients. Patients who had hematuria or
pyuria on urinalysis, had signs of stone, pyelonephritis, or
pyelonephrosis on urinary US and had positive urine culture were
excluded from the study. Every patient had obstetric consultation, and
the fetus and pregnancy status were evaluated. The patients included in
the study were hospitalized, administered intravenous fluid replacement,
paracetamol as analgesic, oral nitrofurantoin as antibiotic and were
recommended bed rest. Antibiotic treatment was initiated as a
prophylaxis and was given for 5 days. This antibiotic treatment was not
based on any guideline recommendations. Ureteral JJ stents were placed
in patients who did not respond to conservative treatment.
In the statistical comparison of the data, compliance with normal
distribution was evaluated with Kolmogorov Smirnov analysis. Mann
Whitney U test was employed for continuous data and chi-square test for
categorical data. Covariance of the degree of hydronephrosis and the VAS
score values were evaluated with Spearman Correlation analysis. (In
the interpretation of the correlation coefficient, values were
categorized as follows: 0.0-0.24 weak, 0.25-0.49 medium, 0.50-0.74
strong, 0.75-1.00 very strong). For statistical significance, in the
95% confidence interval, p value below 0.05 was considered significant.
SPSS v 21.0 program was used for statistical analysis.