Renal colic during pregnancy
Any severe pain during pregnancy is cause for concern and should not be ignored. Renal colic is one such condition – it is accompanied by sharp, intense pain, often described as more severe than labor contractions. Renal colic does not directly threaten the health and life of the mother or baby, but colic attacks should not be ignored, and any disturbing symptom should be reported to a doctor.
What is renal colic and how does it occur?
Renal colic most often appears in the second or third trimester of pregnancy and affects an average of 1 in 3,000 women. The characteristic pain is located in the lower back; it most often affects one side and can sometimes radiate to the perineum or groin. The pain is dull, very severe, sharp, disabling, and can become more severe. The pain may also be accompanied (but not always have to be) by nausea or vomiting, increased body temperature, weakness, painful bladder pressure, and a change in urine consistency or blood in the urine.
What are the causes of renal colic during pregnancy?
There are several causes of renal colic during pregnancy – these include kidney stones, untreated or complicated urinary tract infections, pressure of the enlarged uterus on the bladder, kidneys or ureters, or hormonal changes typical of pregnancy.
Renal colic in the course of urolithiasis is merely a consequence, a pain that occurs as a result of deposits forming in the urinary tract. These stones can be detected on abdominal ultrasound, most often in the kidneys or bladder. Their formation is facilitated by abnormal urine pH, resulting from factors such as poor diet, taking certain medications, and dehydration, often resulting from insufficient fluid intake. A colic attack in urolithiasis is associated with the movement of the stones through the urinary tract, which can lead to urinary retention in the kidney and the associated increase in pressure in the upper urinary tract.
What should future mothers do in such a situation?
Renal colic associated with urolithiasis should absolutely not be ignored, as complications (e.g., pyelonephritis) can even contribute to preterm labor. Any woman who has had problems with urolithiasis before pregnancy should be in constant contact with her gynecologist and address any pain symptoms. Urinary tract infections during pregnancy should always be consulted with the doctor or midwife managing the pregnancy. Urinary tract infections can cause severe pain resulting from muscle spasms and impaired urine flow. Urinary tract infections are common during pregnancy because the enlarging uterus begins to press on the ureters connecting the kidneys to the bladder, impeding urine flow. Gestational diabetes is also a factor – in some cases, glucose can appear in a urinalysis, making urine an ideal breeding ground for bacteria. To prevent the consequences of infection, you should perform the recommended monthly general urinalysis, urine culture if necessary, and promptly visit a doctor if disturbing symptoms appear (frequent urination, painful bladder pressure, pain/stinging when urinating, passing frequent but small amounts of urine).
Renal colic pain may also be caused by pressure from the uterus on the kidneys, ureters, and bladder, which makes it difficult for urine to flow and be eliminated.
What should you do in case of renal colic?
If you experience severe pain, you should make an appointment with an obstetrician-gynecologist in Lublin, preferably the same one who is supervising your pregnancy, or if necessary, with a urologist.
During the visit, a thorough interview will be conducted, tests will be analyzed, and appropriate tests will be ordered (e.g., urinalysis, urine culture, abdominal ultrasound, complete blood count, CRP). Appropriate treatment and management will also be implemented, including non-pharmacological options. Antispasmodic, anti-inflammatory, and pain relievers, approved for use during pregnancy, are helpful. In cases of urolithiasis, medications to dissolve urinary tract stones may be necessary. Fortunately, hospitalization is only necessary in severe cases or if treatment fails.
What can you do to prevent renal colic or alleviate the symptoms?
It's recommended to drink a sufficient amount of water daily – at least 2 liters on average (more at high temperatures), which will help with frequent urination and prevent the formation of deposits. Physical activity, such as walking, is recommended to prevent the uterus from pressing on the urinary tract, promote the spontaneous excretion of deposits in the urine, and prevent urinary retention. A proper diet also plays a significant role – it's recommended to avoid highly processed foods (ready-made products, cakes, sweets, etc.), large amounts of salt, and spicy foods, minimize the consumption of foods high in oxalates (spinach, rhubarb, sorrel, beets, strong teas, coffee), and avoid calcium supplements – calcium intake in a standard diet, which includes dairy products, is sufficient to meet the needs of both the mother and the baby. It's also worth consulting with a doctor about the use of warming compresses on the lower back for renal colic during pregnancy.
Midwife Katarzyna Wiśniewska-Ślepaczuk
Medical consultation: Agnieszka Puchalska, MD, PhD
obstetrician-gynecologist
Provides gynecological and obstetrical advice,
conducts research such as:
- Colposcopy
- Endometrial aspiration biopsy (Pipella)
- Polyp removal
- Vulvoscopy
Frequently asked questions – FAQ
What is renal colic in pregnancy?
Renal colic during pregnancy is a severe, sharp pain most often associated with obstructed urine flow or urolithiasis. The pain is sometimes described as very intense and should not be ignored, even though renal colic itself does not directly threaten the health or life of the mother or baby.
When does renal colic most often occur during pregnancy?
Renal colic most often appears in the second or third trimester of pregnancy. It affects an average of 1 in 3,000 pregnant women.
How does renal colic hurt during pregnancy?
The pain of renal colic is usually located in the lower back, most often on one side. It can radiate to the groin or perineum, and can be dull, severe, or sharp, and can become progressively more severe and impair normal functioning.
What symptoms may accompany renal colic during pregnancy?
Renal colic may be accompanied by nausea, vomiting, increased body temperature, weakness, painful bladder pressure, changes in urine consistency, and blood in the urine. These symptoms may not occur in every woman.
What are the causes of renal colic in pregnancy?
Renal colic during pregnancy may be caused by kidney stones, untreated or complicated urinary tract infections, pressure of the enlarged uterus on the bladder, kidneys or ureters, and hormonal changes typical of pregnancy.
How does renal colic occur in urolithiasis?
In urolithiasis, pain occurs as a result of deposits forming in the urinary tract, which then begin to form stones. Colic attacks are associated with the movement of the stones through the urinary tract, which can lead to urinary retention in the kidney and increased pressure in the upper urinary tract.
What contributes to the formation of stones in the urinary tract?
The formation of stones may be promoted by an incorrect urine pH, an inappropriate diet, taking certain medications and dehydration, often resulting from drinking too little fluid.
Is renal colic during pregnancy dangerous?
Renal colic doesn't directly threaten the health and life of the mother or baby, but it shouldn't be ignored. Complications, such as pyelonephritis, can even contribute to preterm labor.
What to do with renal colic during pregnancy?
If you experience severe pain, you should schedule an appointment with an obstetrician-gynecologist as soon as possible, preferably the one who has been managing your pregnancy, or if necessary, a urologist. It's a good idea to report any disturbing symptoms during pregnancy to your doctor.
What tests are performed for renal colic during pregnancy?
Your doctor may order tests such as urinalysis, urine culture, abdominal ultrasound, complete blood count, and CRP. The scope of testing depends on the patient's symptoms, history, and condition.
How is renal colic treated during pregnancy?
Treatment may include non-pharmacological measures and antispasmodic, anti-inflammatory, and pain-relieving medications approved for use during pregnancy. In the case of urolithiasis, medications that dissolve urinary stones are sometimes necessary.
Does renal colic during pregnancy require hospitalization?
Hospitalization is only necessary in severe cases or when there is no response to treatment. The decision is made by the doctor after assessing the patient's condition and test results.
How to prevent renal colic during pregnancy?
For prevention, it's important to drink plenty of water—on average, at least 2 liters a day, and more in high temperatures. Physical activity, such as walking, is also helpful, as it can support proper urine flow and prevent urinary retention.
What diet is recommended for those at risk of renal colic during pregnancy?
It is recommended to avoid highly processed foods, large amounts of salt, spicy products and limit meals rich in oxalates, such as spinach, rhubarb, sorrel, beets, strong teas and coffee.
Should calcium be supplemented for renal colic during pregnancy?
Calcium supplementation alone is not recommended. A standard diet that includes dairy products usually provides sufficient calcium to meet the needs of both mother and child.
Can warming compresses be used for renal colic during pregnancy?
It's best to consult your doctor about using heat packs on your lower back. During pregnancy, you shouldn't try pain relief methods on your own without first confirming their safety.
The information contained in this article is for general informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. It is recommended that you consult a physician or other qualified healthcare professional for advice regarding specific symptoms, ailments, or health conditions.