How to Relieve Lower Back Pain Caused by Hydronephrosis During Pregnancy

Hydronephrosis during pregnancy is often linked to kidney stones, which can shift and enter the ureter—especially when small in size. Once lodged in the ureter, these stones may block urine flow, leading to renal colic and persistent lower back or flank pain. Pregnant women require special medical consideration, particularly during the first trimester, as certain diagnostic procedures and medications can potentially affect fetal development.

Safe Diagnostic Approaches for Pregnant Women

During early pregnancy, exposure to radiation should be strictly avoided. Instead of X-rays, healthcare providers typically recommend ultrasound (US) or magnetic resonance imaging (MRI)—both non-invasive and radiation-free methods—to accurately detect kidney stones or assess the extent of hydronephrosis. These imaging techniques are considered safe throughout all stages of pregnancy and provide reliable diagnostic information without risking harm to the developing baby.

Managing Mild to Moderate Pain Safely

For mild discomfort or intermittent pain, doctors may prescribe antispasmodic medications such as anisodamine (commonly known as 654-2) or progesterone-like agents, which help relax the smooth muscles of the urinary tract and alleviate spasms. These drugs are generally regarded as low-risk during pregnancy when used under medical supervision, offering effective relief without compromising fetal safety.

When Fever or Severe Symptoms Occur

If a pregnant woman develops intense pain accompanied by fever or signs of infection, prompt medical attention is essential. In such cases, intravenous antibiotics like cephalosporins or penicillins are commonly administered—they are well-tolerated during pregnancy and effective against urinary tract infections that may complicate hydronephrosis.

Cautious Use of Strong Painkillers

Opioid-based analgesics such as pethidine (Demerol) or strong analgesics like morphine derivatives should be used with extreme caution, especially in the first trimester. These medications carry potential risks for fetal abnormalities or neonatal withdrawal symptoms and are usually reserved only for severe, unmanageable pain when no alternatives exist.

Minimally Invasive Intervention Options

In cases of persistent, severe obstruction causing significant pain and kidney swelling, minimally invasive procedures may be considered. Under local anesthesia, a urologist can perform a cystoscopy and place a double-J (DJ) stent into the ureter. This small tube helps bypass the blockage, allowing urine to drain properly from the kidney to the bladder. As drainage improves, pressure on the kidney decreases, often resulting in rapid symptom relief and resolution of hydronephrosis.

Timing Treatment: Waiting Until After Delivery

For women in their second or third trimester, diagnostic flexibility increases, and more treatment options become available. However, unless complications arise, most physicians advise delaying definitive stone removal procedures—such as lithotripsy or surgical extraction—until after childbirth. This approach minimizes risks to both mother and baby while ensuring optimal recovery conditions postpartum.

Ultimately, managing hydronephrosis during pregnancy requires a careful balance between maternal comfort and fetal well-being. With proper monitoring, safe imaging, and timely interventions, most women can navigate this condition successfully and maintain a healthy pregnancy journey.