With higher fetal weight and a longer duration of pregnancy, the latter, by contributing to impaired urodynamics in patients operated on for vesicoureteral reflux, can create a new risk for the decompensated function of the vesicoureteral segment due to compression with the pregnant uterus. The paper describes a clinical case of pregnancy and childbirth in a female patient with urinary tract anomaly, bilateral reflexing megaureter, who have undergone ureterocystoneostomy performed with the Leadbetter—Politano antireflex technique at the age of 6 years, and with chronic pyelonephritis. The investigators conducted a thorough, dynamic monitoring of the pregnant woman’s status: creatinine levels, glomerular filtration rate, degree of dilation of the upper urinary tract, body temperature, blood pressure values, and signs of urinary tract infection. The current marker of preeclampsia, namely an angiogenic factor, was investigated; a multidisciplinary approach to managing this pregnant woman was applied. Due to transformation of recurrent vesicoureteral reflux in obstructive ureterohydronephrosis related to compression of the lower ureters with the pregnant uterus, to an increase in the creatinine value of more than 200 µmol/l, an internal drainage of the kidney and bladder was carried out through bilateral ureter stenting and vesical placement of a Folley catheter at 31 weeks’ gestation. It was noted that this operation should have been done earlier — at the beginning of the second half of pregnancy. The paper emphasizes that the favorable outcome of pregnancy in patients with refluxing megaureter depends on a dynamic individual intensive multidisciplinary observation, clinical, laboratory, and instrumental examinations of the patient, timely correction of disorders, and good compliance in female patients themselves.