The urinary tract in pregnancy

The growth and development of the fetus stimulate dramatic alterations in the maternal internal environment. Morphological and functional changes in the urinary tract are particularly prominent aspects of this adaptive process and have been studied extensively during the last several decades. Such changes may include increased renal size, anatomic changes in the collecting system, alterations in renal hemodynamics and variations in the levels of circulating plasma hormones. These alterations can affect normal renal function and pre-existing renal disease, as well as predispose the pregnant women to de novo renal disease. The urinary tract alterations associated with pregnancy, their clinical and pathological manifestations, and their management are reviewed herein.