Maternal and neonatal outcomes of ultrasound-guided percutaneous nephrostomy for symptomatic hydronephrosis in pregnancy: a retrospective cohort study.

OBJECTIVES

To evaluate the maternal and neonatal outcomes of pregnant patients who underwent ultrasound-guided percutaneous nephrostomy for the management of symptomatic hydronephrosis.

METHODS

This retrospective cohort study evaluated 85 pregnant patients with symptomatic hydronephrosis (≥ Grade 2) managed at a tertiary center between January 2020 and February 2025. Participants were stratified into ultrasound-guided PCN (n=43) and conservative management (n=45) groups. The primary outcome of this study was to evaluate the safety and efficacy of ultrasound-guided PCN in pregnant patients with symptomatic hydronephrosis.

RESULTS

Demographic characteristics were similar between groups. Abdominal pain was more common in the conservative group (45.5 % vs. 26.8 %, p=0.062), while other clinical and laboratory parameters showed no significant differences. Antibiotic use differed significantly (p=0.016), though urine culture results were comparable. Pregnancy and neonatal outcomes, including gestational age at delivery, birth weight, Apgar scores, cesarean delivery rates, and neonatal intensive care unit (NICU) admission rates, did not differ significantly between groups (all p>0.05). Kaplan-Meier survival analysis demonstrated no statistically significant difference in cumulative live birth rates between the PCN and conservative treatment groups (log-rank test, p=0.665), with hazard ratios indicating comparable reproductive outcomes over time.

CONCLUSIONS

This study demonstrates that ultrasound-guided PCN is a safe and effective intervention for managing symptomatic hydronephrosis during pregnancy, with favorable maternal and neonatal outcomes. Further prospective studies with larger cohorts are warranted to validate these findings and refine clinical guidelines.