To explore the management of ureteral calculi in pregnancy, and to observe the postoperative outcomes.

204 pregnant patients with ureteral calculi were admitted to the First Affiliated Hospital of Guangzhou Medical University from July 2017 to February 2021. Conservative treatment was administrated after admission, if symptoms had no obvious improvement, or indications of operation was noted, patitens got a surgical management, such as ureteroscopy, ureteroscopic lithotripsy and nephrostomy. Visual analog scale (VAS) was used to evaluate the pain before and after treatment. All patients were followed up for 1 year, the treatment and outcomes were recorded.

The symptoms were relieved after conservative treatment in 83 cases. 82 cases were stone free in postpartum review, and 1 case required ureteroscopic lithotripsy. 121 patients received surgical treatment and the symptoms were relieved, of which 109 cases were stone free, 9 cases required ureteroscopic lithotripsy after delivery, and 3 cases received auxiliary extracorporeal lithotripsy. Symptoms and hydronephrosis were all relived in all 204 cases, 199 cases delivered normal fetus , abortion was noted in 5 cases. In one-year follow-up, no obvious abnormality was found in mother and infant. Renal insufficiency restored to normal after surgical treatment in 2 patients. The VAS score of patients who adopted conservative treatment after treatment was (1.84±0.37), which was lower than that (6.85±0.94) before treatment (P<0.001). The VAS score of surgical patients after treatment was (1.05±0.25), which was lower than that (6.89±0.96) before treatment (P<0.001).

Conservative treatment is the first choice for ureteral calculi in pregnancy. However, surgical treatment is reqiured in patients with poor response to conservative treatment, uroteroscopic lithotripsy, ureteral stenting or percutaneous nephrostomy are also safe and effective.