To define current national practice patterns of imaging modalities and urologic procedures in pregnant women with urinary stone disease.
Using the IBM® MarketScan® national insurance claims database, we identified pregnant women with urinary stone disease and their corresponding gestational age between 2011-2016 using administrative claims data.
We then assessed each encounter for urinary stone disease or stone-related urologic procedure during their pregnancy. We abstracted demographic information as well as codes for stone procedures and imaging.
We identified 14,298 pregnant women with urinary stone disease during the study period. Of the 12,315 undergoing abdominal imaging (86.1%), magnetic resonance imaging (MRI) in 2.8%, x-ray in 9%, and ultrasound in 74.3%. Computed tomography was not used as a diagnostic modality during pregnancy. Procedural intervention was performed in 749 women (5.2%): 476 (3.3%) ureteral stent placement without definitive stone treatment, 93 (0.6%) percutaneous nephrostomy placement, and 180 (1.3%) ureteroscopy (URS) for definitive stone treatment. URS was most commonly performed before 34 weeks gestation with only 27 cases (15%) performed after.
This large national cohort reveals the current imaging and procedural practice patterns for urinary stone disease during pregnancy and provides a critical baseline as these practice patterns evolve in the future.
Urology. 2020 Apr 17 [Epub ahead of print]
Kyle Spradling, Ericka M Sohlberg, Shufeng Li, Chiyuan Amy Zhang, William D Brubaker, Kai Dallas, Alan C Pao, Joseph Liao, John T Leppert, Christopher S Elliott, Benjamin I Chung, Gyeong Eun Min, Simon L Conti
Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Division of Nephrology, Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA; Division of Nephrology, Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA; Division of Urology, Santa Clara Valley Medical Center, San Jose, CA. Electronic address: ., Department of Urology, Stanford University School of Medicine, Stanford, CA. Electronic address: ., Department of Urology, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea., Department of Urology, Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32311447