Urinary Stone Disease in Pregnancy: Current Management Practices in a Large National Cohort



      To define current national practice patterns of imaging modalities and urologic procedures in pregnant women with urinary stone disease.


      Using the IBM MarketScan national insurance claims database, we identified pregnant women with urinary stone disease and their corresponding gestational age between 2011 and 2016 using administrative claims data. We then assessed each encounter for urinary stone disease or stone-related urologic procedure during their pregnancy. We abstracted demographic information as well as codes for stone procedures and imaging.


      We identified 14,298 pregnant women with urinary stone disease during the study period. Of the 12,315 undergoing abdominal imaging (86.1%), magnetic resonance imaging was used in 2.8%, x-ray in 9%, and ultrasound in 74.3%. Computed tomography was not used as a diagnostic modality during pregnancy. Procedural intervention was performed in 749 women (5.2%): 476 (3.3%) ureteral stent placement without definitive stone treatment, 93 (0.6%) percutaneous nephrostomy placement, and 180 (1.3%) ureteroscopy (URS) for definitive stone treatment. URS was most commonly performed before 34 weeks gestation with only 27 cases (15%) performed after.


      This large national cohort reveals the current imaging and procedural practice patterns for urinary stone disease during pregnancy and provides a critical baseline as these practice patterns evolve in the future.
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        • Stamatelou KK
        • Francis ME
        • Jones CA
        • et al.
        Time trends in reported prevalence of kidney stones in the United States: 1976-1994.
        Kidney Int. 2003; 63: 1817-1823
        • Scales CD
        • Smith AC
        • Hanley JM
        • et al.
        Prevalence of kidney stones in the United States.
        Eur Urol. 2012; 62: 160-165
        • Sohlberg EM
        • Brubaker WD
        • Zhang CA
        • et al.
        Urinary stone disease in pregnancy: a claims-based analysis of 1.4 million patients.
        J Urol. 2019;
        • Ordon M
        • Dirk J
        • Slater J
        • et al.
        Incidence, treatment and implications of kidney stones during pregnancy- a matched population-based cohort study.
        J Endourol. 2019;
        • De Santis M
        • Di Gianantonio E
        • Straface G
        • et al.
        Ionizing radiations in pregnancy and teratogenesis: a review of literature.
        Reprod Toxicol. 2005; 20: 323-329
        • Bajwa SJ
        • Bajwa SK
        Anaesthetic challenges and management during pregnancy: strategies revisited.
        Anesth Essays Res. 2013; 7: 160-167
        • Meria P
        • Hadjadj H
        • Jungers P
        • et al.
        Stone formation and pregnancy: pathophysiological insights gained from morphoconstitutional stone analysis.
        J Urol. 2010; 183: 1412-1416
        • Ailes EC
        • Simeone RM
        • Dawson AL
        • et al.
        Using insurance claims data to identify and estimate critical periods in pregnancy: an application to antidepressants.
        Birth Defects Res Part A - Clin Mol Teratol. 2016; 106: 927-934
        • Swartz MA
        • Lydon-Rochelle MT
        • Simon D
        • et al.
        Admission for nephrolithiasis in pregnancy and risk of adverse birth outcomes.
        Obstet Gynecol. 2007; 109: 1099-1104
        • Miller OF
        • Kane CJ
        Time to stone passage for observed ureteral calculi: a guide for patient education.
        J Urol. 1999; 162: 688-690
        • Cheng RZ
        • Shkoylar E
        • Chang TC
        • et al.
        J Endourol. 2019; (Oct 30)
        • Andreoiu M
        • MacMahon R
        Renal colic in pregnancy: Lithiasis or physiological hydronephrosis?.
        Urology. 2009; 74: 757-761