Pyonephrosis Pregnancy Emergency Decompression — ESENeph MCQ

Correct answer: A — Give pregnancy-compatible antibiotics and urgently decompress the collecting system

The best answer is “Give pregnancy-compatible antibiotics and urgently decompress the collecting system”. Ureteric stent or percutaneous nephrostomy provides urgent drainage; definitive stone treatment follows stabilization with obstetric, urology and anaesthetic coordination. “Arrange shock-wave lithotripsy after pregnancy when clinically appropriate” is less appropriate because ESWL is contraindicated and does not address immediate sepsis safely “Use antibiotics without drainage when imaging excludes an infected obstruction” is less appropriate because pyonephrosis and sepsis distinguish pathological obstruction “Plan definitive ureteroscopy after drainage and control of maternal sepsis” is less appropriate because delay risks maternal and fetal deterioration “Observe when symptoms settle and infection and obstruction have been excluded” is less appropriate because infected obstruction is immediately life threatening

Reference: EAU guideline on urolithiasis: https://uroweb.org/guidelines/urolithiasis/chapter/guidelines