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Objective To review published cases of rupture of the urinary tract during pregnancy and illustrate the clinical manifestations of this serious complication of pregnancy. Methods Reported cases of urinary tract rupture were reviewed and a new case described. Results Spontaneous rupture of the urinary tract during pregnancy is rare; a review of the literature revealed only 24 cases, most commonly occurring in diseased kidneys. In the majority of cases the rupture was associated with underlying diseases of the kidney, the most common being renal tumours. Of the 25 cases examined, 12 had ruptures of the collecting system and 13 had ruptures of the renal parenchyma; 21 were diagnosed during pregnancy in the second and third trimester and four within the first 24 h postpartum. Conclusion Pregnancy-induced changes in the urinary tract exaggerate any weakness of the parenchyma or collecting system. Pregnant patients with overdistension of the upper urinary tract should undergo routine ultrasonography and be observed carefully for infection or haematuria. [ABSTRACT FROM AUTHOR]