- 期刊
Bilateral Ureteral Obstruction by Compression of Gravid Uterus Resulting in Bilateral Hydronephrosis and Reversible Acute Renal Failure during Third Trimester Pregnancy: A Case Report
懷孕後期變側輸尿管阻塞導致變側腎水腫及可逆性急性腎衰竭：個例報告
並列摘要
Objective: Acute renal failure caused by obstruction of ureters due to compression of a gravid uterus is extremely rare. We presented a case of bilateral ureteral obstruction by compression of gravid uterus leading to bilateral hydronephrosis and acute renal failure. Acute renal failure spontaneously resolved after termination of the pregnancy. Case Report: An 18-year-old female, gravida 1, para 0, was referred at 33 weeks of gestation with twin pregnancy. She suffered from weight gain, decreased urine output, and bilateral flank pain for 10 days. Elevated blood urea nitrogen (BUN: 49.6 mg/dL) and creatinine (5.1 mg/dL) were identified. Ultrasonographic examination revealed bilateral hydroureter and hydronephrosis. Acute renal failure caused by obstructive uropathy because an enlarged gravid uterus was therefore diagnosed. Termination of pregnancy was performed. The levels of blood nitrogen level and creatinine were decreased since 12 hours after delivery and returned to normal limits at the time of discharge from the hospital. Hydronephrosis was also improved after termination of pregnancy. Conclusion: Clinicians should be aware of the rare possible cause of acute renal failure by obstructive uropathy because of an enlarged gravid uterus. Careful history taking, physical examination, and laboratory survey can help us clarify the etiology.
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