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.