Figure 101

Anatomic changes in the kidney during pregnancy. During pregnancy, kidney size increases by about 1 cm. More striking are the changes in the urinary tract. The calyces, renal pelvis, and ureters dilate. The dilation is more marked on the right side than the left and is apparent as early as the first trimester. Hormonal mechanisms and mechanical obstruction are responsible. Intravenous pyelography may demonstrate the iliac sign in which ureteral dilation terminates at the level of the pelvic brim where the ureter crosses the iliac artery. Ureteral dilation and urinary stasis contribute to the increased incidence of asymptomatic bacteriuria and pyelonephritis in pregnancy.

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