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ACOG pregnancy kidney stones hydronephrosis warning symptoms guidance
What the ultrasound report says
- Pregnancy: A single live fetus is seen, measuring approximately 27 weeks 6 days.
- Kidneys/ureters: Both kidneys have minimal hydronephrosis and dilation of the upper ureters. The radiologist believes this is from the pregnant uterus pressing on the lower ureters, which is a common pregnancy-related finding.
- Urine flow: Normal urine jets are seen at the bladder entry points of the ureters, which supports that urine is still passing through.
- Kidney stones: Small non-obstructing stones in both kidneys:
- Right: about 3.3 mm
- Left: about 3.7 mm in the upper pole and additional small lower-pole stone(s), reported around 4.2-4.4 mm
- Other abdominal organs: Liver, gallbladder, spleen, pancreas, bladder, bowel, aorta, and IVC appear normal. No free fluid or abdominal mass is reported.
Meaning
This does not describe a blocked kidney stone at present. The mild swelling of both kidneys is most likely due to pressure from the uterus at this stage of pregnancy, and it often improves after delivery. Hydronephrosis is commonly seen in pregnancy and is usually not disease-related, although symptoms and kidney function still need follow-up. A 2024 systematic review found that intervention is generally reserved for people whose symptoms or complications progress. Review of pregnancy hydronephrosis
The stones are small and are currently described as non-obstructive, but they can still cause pain, blood in urine, infection, or occasionally move into a ureter.
What to do
Please show this report to your obstetrician soon, and consider a urologist if there is continuing pain. They may decide to check:
- urine routine/culture, especially to rule out infection
- blood pressure and kidney-function tests
- repeat ultrasound if pain persists or worsens
Do not start stone medicines, herbal remedies, or pain medicines without your obstetrician’s approval during pregnancy.
Seek urgent care today if any of these occur
- Fever, chills, or burning/painful urination
- Severe or worsening one-sided back/flank or abdominal pain
- Vomiting or inability to keep fluids down
- Blood in urine
- Reduced urine output
- Contractions, vaginal bleeding, leakage of fluid, or reduced fetal movements
One point to clarify with the radiology center: the report writes fetal length as “FL 5.2 mm” while dating the pregnancy at 27 weeks 6 days. That is likely intended to be 52 mm, but it should be confirmed, especially if this was meant to be a fetal growth scan.
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