Clinical presentation and management of urolithiasis in the obstetric patient: a matched cohort study

Autor: Andrea R. Spence, Natasha Sebastian, Haim A. Abenhaim, Nicholas Czuzoj-Shulman
Rok vydání: 2021
Předmět:
Zdroj: The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 35(25)
ISSN: 1476-4954
Popis: Purpose To evaluate the effect of pregnancy on the clinical presentation, inpatient procedure rates, and length of hospital stay, on women with urolithiasis. Materials and methods We carried out a matched cohort study using the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database from 1999 to 2015. Pregnant women with urolithiasis were compared to age-matched non-pregnant women (1:1) with urolithiasis. Baseline clinical characteristics were compared between the two cohorts and the effect of pregnancy on select inpatient procedural and clinical outcomes was evaluated using conditional logistic regression models. Results There were 42,113 pregnant patients diagnosed with urolithiasis during the study period. It was observed that pregnant patients were less likely to present with classic clinical symptoms of urinary tract stones, such as flank pain, OR 0.63, 95% CI 0.56-0.70, and fever, 0.22 (0.16-0.30), but tended to have longer hospital stays. The pregnant patients were less commonly affected by infectious conditions, namely urinary tract infections, 0.56 (0.53-0.59), sepsis, 0.17 (0.14-0.20), and pyelonephritis, 0.34 (0.36-0.44). Invasive and surgical procedures were less commonly performed in pregnant women. Conclusions Pregnant women admitted with urolithiasis appear to be less symptomatic with fewer interventions and complications than non-pregnant women with urolithiasis.
Databáze: OpenAIRE