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Summary A 20‐year‐old woman with severe renal failure (serum creatinine 7 mg./100 ml.; blood urea 250 mg./100 ml.) was subjected to haemodialysis from the 24th to the 30th week of pregnancy in order to increase the chance of fetal survival. She had previously had 2 abortions at 16‐20 weeks. The blood urea level during dialysis varied between 25 and 98 mg./100 mi., and the serum creatinine between 2.4 mg. and 7.2 mg./100 ml. The patient developed marked polyhydramnios during the 27th week of gestation which ultimately led to premature delivery of a 1,020 g. female child who survived only 12 hours. Hyperparathyroidism also developed during the pregnancy. For the 14 months after delivery the patient's renal function has remained stable with conservative management. Haemodialysis should be considered during pregnancy if there is a sudden deterioration of renal function or development of hypertension which threatens the fetus before viability. Careful attention to anaemia, calcium malabsorption and other effects of chronic renaI failure which are less responsive to dialysis is also essential.
Pepperell et al. (Sat,) studied this question.