How do you evaluate for clinically significant ureteral obstruction in a pregnant patient with AKI, since physiological hydronephrosis on kidney ultrasound is common?

How would you evaluate for clinically significant ureteral obstruction in a pregnant patient with AKI, given that physiological hydronephrosis on kidney ultrasound is common?

• Perform a renal Doppler ultrasound to assess for blood flow abnormalities
• Use a non-contrast MRI to evaluate
• Place a Foley catheter to rule out lower urinary tract obstruction first
• Monitor closely with serial kidney ultrasounds and additional imaging only if symptoms persist or worsen
• Consult urology for direct ureteral evaluation, such as ureteroscopy
• Other