The incidence and significance of urinary calculi in pregnancy

The symptoms of urinary calculi during the first 4 months and the last month of pregnancy are similar to those of the nonpregnant patient, with coliclike pain more common. After the fourth month of gestation, the symptoms are atypical and the presence of kidney infection is the more common indication of urinary calculi. Thirty-five patients with urinary calculi diagnosed prior to, during, and after pregnancy are presented. Urologic evaluation should be done in pregnant patients with (a) symptoms suggestive of calculi, (b) a previous history of calculi, (c) unusually severe symptomatic pyelonephritis, (d) recurrent symptomatic urinary tract infection, and (e) unresponsive symptomatic urinary tract infection. The treatment of urinary calculi during pregnancy is individualized.