You are pregnant and suddenly start to feel a strange sensation — not sure if it’s pain or discomfort. But the sensation begins to turn into pain, and it’s located in your back, radiating to the front. The pain keeps getting stronger, making you more uncomfortable and feeling worse by the minute. The pain reaches a point where you can’t find relief in any position — lying down, standing, sitting… Any position will bother you! At some point, you can’t take the pain anymore and rush to the emergency room to find out what is happening and the doctor’s exam, even from a clinical perspective, already suspects: kidney stones!
The pain during kidney stone attacks is extremely intense! Those who have been through it say it’s very similar to labor pain, sometimes even more intense! That’s why it’s so unpleasant when it hits. But what causes kidney stones during pregnancy and how do you deal with this pain? Kidney stones in pregnancy do not actually form during pregnancy, but rather beforehand. What happens is that with the increase of progesterone and other hormones, the kidney ends up dilating, making it more likely to release the stones that were already there1.
Kidney stones are formed by the accumulation of calcium oxalate and calcium phosphate crystals, as well as crystals of uric acid2. Eighty percent of stones are made up of calcium and 10% of uric acid. Stone formation is favored when there is low fluid intake and high consumption of foods that increase these substances in the kidney. By the way, the kidney is a very important organ — all fluids and also the blood in the body pass through it. Filtering these fluids causes excess urinary crystals to accumulate in the kidney, which leads to the formation of kidney stones. Most of the time, stones take years to form and stay quietly in the kidney. But when they start to move, that’s when the problem occurs: as they exit, pain arises, especially when the stone is large and blocks the passage of urine from the kidney to the bladder like a cork.
Urine reflux creates a lot of pressure in the ureter (the tube connecting the kidney to the bladder) and ends up returning to the kidney, which causes the kidney to swell and, consequently, pain. This backup of urine can cause several problems besides pain, with one of the most common being infection. The infection can reach the bladder or, worse, the kidneys themselves. The issue is when a kidney stone attack happens during pregnancy, a time when the body cannot receive proper treatment due to the developing baby, as well as being unable to use the appropriate medications and necessary procedures.
The consequences of kidney stones can result in severe problems in pregnancy; depending on the stage, it can cause miscarriage or even premature birth. However, it does not cause harm to the fetus, neither do the kidney stone attacks nor the passage of the stone. In summary, it does not cause birth defects. It is important to take care to ensure that the situation does not worsen and lead to bigger problems.
How to Diagnose and Treat Kidney Stones During Pregnancy
Kidney stones during pregnancy can only be diagnosed through a urine test, which will check for the presence of calcium oxalate crystals or blood (from minor injuries caused by the stones). There is a more efficient way to locate this problem, but it involves an exam that pregnant women cannot undergo: a CT scan, which exposes the body to a lot of radiation and is not recommended due to the risk to fetal development.
The treatment for kidney stones in pregnancy is to drink plenty of fluids to help the body eliminate the stone naturally. If the stone is too large to pass on its own, a procedure called endoscopic surgery (through the urethra) is recommended. This procedure locates the stone, then it is broken up with a laser and the pieces are retrieved with a catheter called double J through the urinary tract. The procedure does not involve any incisions or stitches. Treatment during pregnancy is kept as simple as possible to avoid being invasive; if necessary, the doctor will recommend a more comprehensive procedure after pregnancy3.
If complications such as infection occur, the doctor will treat with antibiotics appropriate to the stage of pregnancy, and, if necessary, corticosteroids. During an attack, immediately seek an emergency room, preferably one with urology support. Medical evaluation is crucial to determine the best approach during pregnancy and ensure proper treatment.
Author’s note: I had kidney stones during all my pregnancies. The first was the worst — three attacks with three different stones! In the others, I had only one crisis, but in each, I managed to “catch” the troublesome stone.
Also see: Pain During Pregnancy – What’s Normal?Photos: mirkop82
