The identification of pregnant women with renal colic who may need surgical intervention

Abstract Objectives: To analyze clinical data and stone-related factors to identify predictive factors for surgical intervention in pregnant women with renal colic. Methods: We conducted a retrospective review of 212 pregnant women presenting with renal colic between 1st January 2009 and 31st December 2019. Patients were grouped according to surgical intervention and a range of demographic, clinical, laboratory, and ultrasound data were obtained. Univariate and multivariate analyses identified a range of predictive variables for surgical intervention. In addition, we used receiver operating characteristic (ROC) curve analysis to evaluate the predictive power of our model and created a nomogram for clinical application. Results: Of the 212 patients presenting with acute renal colic in pregnancy, 100 patients (47.2%) underwent surgical intervention and 112 patients (52.8%) were treated conservatively. Univariate analysis identified significant differences between the two groups with regards to fever, the duration of pain, white blood cells (WBCs), C-reactive protein (CRP), ureteral stone size, hydronephrosis, and stone location. Multivariate analysis further identified a number of independent predictors for surgical intervention, including fever, a duration of pain ≥4 days, a ureteral stone size ≥ 8 mm, and moderate or severe hydronephrosis.Conclusions: We identified several independent predictors for surgical intervention for renal colic in pregnancy. Fever, a duration of pain ≥4 days, a ureteral stone size ≥8 mm, and moderate/severe hydronephrosis, play significant roles in predicting surgical intervention. Our nomogram can help to calculate the probability of surgical intervention in a simple and efficient manner. Prospective studies are now required to validate our model.