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Case Reports in Obstetrics and Gynecology
Volume 2015, Article ID 906073, 4 pages
http://dx.doi.org/10.1155/2015/906073
Case Report

Preterm Delivery in the Setting of Left Calyceal Rupture

Inova Fairfax Hospital Department of Obstetrics and Gynecology, 3300 Gallows Road, Falls Church, VA 22042, USA

Received 27 June 2015; Accepted 14 September 2015

Academic Editor: Yoav Peled

Copyright © 2015 Brent Hanson and Rami Tabbarah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI) was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.