{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:54:18Z","timestamp":1791561258710,"version":"4.3.4"},"reference-count":9,"publisher":"Walter de Gruyter GmbH","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2026-0235_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Obstructive uropathy is the impairment of urinary flow resulting from mechanical compression along the urinary tract between the ureter\u2019s origin in the renal pelvis and the urethral outlet. While uncommonly encountered during labor, maternal obstructive uropathy (thought to result from ureteral compression by the fetal head) can be associated with acute kidney injury, and its relationship with clinically meaningful endpoints including risk of cesarean delivery, arrest of labor (previously known as cephalopelvic disproportion (CPD)), and high birthweight remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0235_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case-control, propensity score-matched study using an institutional database of patients who delivered at one of two hospitals within our healthcare system between January 2017 and December 2023, querying the relationship between ICD-9 and ICD-10 diagnostic codes of maternal obstructive uropathy and labor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0235_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The diagnosis of ureteral obstruction was significantly associated with incidence of cesarean delivery (93\u202f% in cases, 16\u202f% in controls, p&lt;0.001) and clinical suspicion for CPD (80\u202f% in cases, 13\u202f% in controls, p&lt;0.001) but was not significantly associated with birthweight (p=0.729).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0235_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that intrapartum diagnosis of obstructive uropathy may portend labor dystocia and subsequent indication for intrapartum cesarean delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2026-0235","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:55:31Z","timestamp":1786528531000},"page":"1293-1296","source":"Crossref","is-referenced-by-count":0,"title":["Maternal obstructive uropathy during labor is a risk factor for cesarean delivery"],"prefix":"10.1515","volume":"54","author":[{"given":"Gregory W.","family":"Kirschen","sequence":"first","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedeja V.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Gynecology & Obstetrics , Johns Hopkins University School of Medicine, The Johns Hopkins Hospital , Baltimore , USA"},{"name":"Division of Maternal-Fetal Medicine, Department of Gynecology & Obstetrics , Johns Hopkins University School of Medicine , Baltimore , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Peeler","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine , University of North Carolina Health , Chapel Hill , NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston , MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Tackett","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine , Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA"},{"name":"Biostatistics, Epidemiology, and Data Management Core , Johns Hopkins School of Medicine , Baltimore , MD , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Argani","sequence":"additional","affiliation":[{"name":"Department of Gynecology & Obstetrics , Johns Hopkins University School of Medicine, The Johns Hopkins Hospital , Baltimore , USA"},{"name":"Division of Maternal-Fetal Medicine, Department of Gynecology & Obstetrics , Johns Hopkins University School of Medicine , Baltimore , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"2026100915172383002_j_jpm-2026-0235_ref_001","unstructured":"Satin, AJ, Seiken, GL, Cunningham, FG. Reversible hypertension in pregnancy caused by obstructive uropathy. Obstet Gynecol 1993;81:823\u20135."},{"key":"2026100915172383002_j_jpm-2026-0235_ref_002","doi-asserted-by":"crossref","unstructured":"Cheung, KL, Lafayette, RA. Renal physiology of pregnancy. Adv Chron Kidney Dis 2013;20:209\u201314. https:\/\/doi.org\/10.1053\/j.ackd.2013.01.012.","DOI":"10.1053\/j.ackd.2013.01.012"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_003","doi-asserted-by":"crossref","unstructured":"Gembillo, G, Spadaro, G, Santoro, D. Link between obstructive uropathy and acute kidney injury. World J Nephrol 2025;14:99120. https:\/\/doi.org\/10.5527\/wjn.v14.i1.99120.","DOI":"10.5527\/wjn.v14.i1.99120"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_004","doi-asserted-by":"crossref","unstructured":"Perez-Aizpurua, X, Cabello Benavente, R, Bueno Serrano, G, Alcazar Peral, JM, Gomez-Jordana Manas, B, Tufet, IJJ, et al.. Obstructive uropathy: overview of the pathogenesis, etiology and management of a prevalent cause of acute kidney injury. World J Nephrol 2024;13:93322. https:\/\/doi.org\/10.5527\/wjn.v13.i2.93322.","DOI":"10.5527\/wjn.v13.i2.93322"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_005","doi-asserted-by":"crossref","unstructured":"Hamdi, A, Hajage, D, Van Glabeke, E, Belenfant, X, Vincent, F, Gonzalez, F, et al.. Severe post-renal acute kidney injury, post-obstructive diuresis and renal recovery. BJU Int 2012;110:E1027\u201334. https:\/\/doi.org\/10.1111\/j.1464-410x.2012.11193.x.","DOI":"10.1111\/j.1464-410X.2012.11193.x"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_006","doi-asserted-by":"crossref","unstructured":"Jena, M, Mitch, WE. Rapidly reversible acute renal failure from ureteral obstruction in pregnancy. Am J Kidney Dis 1996;28:457\u201360. https:\/\/doi.org\/10.1016\/s0272-6386(96)90507-7.","DOI":"10.1016\/S0272-6386(96)90507-7"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_007","doi-asserted-by":"crossref","unstructured":"Maharaj, D. Assessing cephalopelvic disproportion: back to the basics. Obstet Gynecol Surv 2010;65:387\u201395. https:\/\/doi.org\/10.1097\/ogx.0b013e3181ecdf0c.","DOI":"10.1097\/OGX.0b013e3181ecdf0c"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_008","doi-asserted-by":"crossref","unstructured":"O\u2019Kane, M, Rantell, A. Intrapartum and postpartum bladder management: the poor relation of modern obstetrics. Obstet Gynaecol Reprod Med 2023;33:190\u20136. https:\/\/doi.org\/10.1016\/j.ogrm.2023.04.002.","DOI":"10.1016\/j.ogrm.2023.04.002"},{"key":"2026100915172383002_j_jpm-2026-0235_ref_009","doi-asserted-by":"crossref","unstructured":"Brandes, JC, Fritsche, C. Obstructive acute renal failure by a gravid uterus: a case report and review. Am J Kidney Dis 1991;18:398\u2013401. https:\/\/doi.org\/10.1016\/s0272-6386(12)80103-x.","DOI":"10.1016\/S0272-6386(12)80103-X"}],"container-title":["Journal of Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0235\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0235\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:19:48Z","timestamp":1791559188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpm-2026-0235\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,25]]},"published-print":{"date-parts":[[2026,10,26]]}},"alternative-id":["10.1515\/jpm-2026-0235"],"URL":"https:\/\/doi.org\/10.1515\/jpm-2026-0235","relation":{},"ISSN":["0300-5577","1619-3997"],"issn-type":[{"value":"0300-5577","type":"print"},{"value":"1619-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]}}}