Background:
There is limited evidence on the optimal management for use of percutaneous nephrostomy (PCN) during pregnancy. Our aims were to evaluate the indication for PCN during pregnancy, the associated maternofetal outcomes, and to help in the development of clinical guidelines at our tertiary centre.
Methods:
We conducted a single tertiary centre 5-year retrospective review between January 2021 to January 2026. Adults (aged 18 and over) who had a PCN inserted during pregnancy were included. Data was obtained from the electronic medical record and included 1) indication for PCN and 2) maternofetal antenatal and postnatal outcomes.
Results:
13 women underwent PCN insertion, with a mean age of 30 (range, 18-40) and mean gestational age at the time of insertion of 25 weeks (range, 18–34). 6 (46%) had hydronephrosis secondary to renal calculi, 5 (38%) had hydronephrosis without visible calculi and 3 (23%) had pyelonephritis. At PCN insertion 6 (46%) had mild hydronephrosis, 6 (46%) had moderate hydronephrosis and 1 (8%) had severe hydronephrosis. All patients had an improvement in symptoms. 9 (69%) patients required PCN exchange during the pregnancy. 10 (77%) had a readmission to hospital related to the PCN. 8 (61%) developed a PCN associated UTI. The mean gestation at delivery was 38 weeks. No patients developed a major complication related to insertion.
Conclusion:
PCN insertion during pregnancy is a safe procedure with success in improving symptomatic hydronephrosis. However, this intervention is associated with high rates of PCN catheter malfunction, rapid encrustation, PCN associated UTI’s and readmission rates.