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.
Results: 13 women underwent PCN insertion during pregnancy in the study period, with a mean age of 30 (range, 18-40) and mean gestational age of 25+6 weeks (range, 18+3 –34+0). Of the 13 patients undergoing PCN 5 (38%) had symptomatic hydronephrosis without visible calculi, 3 (23%) had symptomatic hydronephrosis with visible calculi, 3 (23%) had pyelonephritis without visible calculi and 2 (15%) had pyelonephritis with visible calculi present. All patients had an initial ultrasound for diagnosis, 3 patients had an additional CT. The average duration for expectant management was 3.4 days in those that did not have obstructive renal calculi or pyelonephritis. 11 (85%) patients required PCN exchange during the pregnancy with 3 (23%). There was encrustation reported at 64% (7/11) of exchanges. 10 (77%) developed a PCN associated UTI. 10 (77%) patients had a catheter malformation (blocked or unable to be exchanged).
Conclusion: PCN insertion during pregnancy was successful 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.