Pregnancies in women on chronic renal dialysis are high-risk with significant rates of prematurity and maternal hypertension, requiring multidisciplinary management.
Supports multidisciplinary care in dialysis pregnancies; leaves open optimal protocols from larger studies.
OBJECTIVE: To study obstetric outcomes in women with end-stage renal failure undergoing chronic renal dialysis. METHODS: A retrospective review of the database from the High-Risk Pregnancy Clinic at Singapore General Hospital, Singapore. RESULTS: From 1995 to 2004, 7 women treated with chronic renal dialysis had a total of 11 pregnancies. There were 2 pregnancy losses at previable gestation ages and 9 live births. Median gestational age at delivery was 31 weeks, and mean birth weight was 1390 g. Seven newborns had a low birth weight and 5 required neonatal intensive care. Severe hypertension occurred in 4 women for a total of 7 pregnancies. Other complications included polyhydramnios (n=2), preterm prelabor rupture of membranes (n=2), obstetric cholestasis (n=2), postpartum hemorrhage (n=1), thrombosis of the arteriovenous fistula (n=2), postpartum peritonitis (n=1), and fetal anomaly (n=1). There were no maternal deaths. CONCLUSION: Such pregnancies are high-risk, particularly because of maternal hypertension and prematurity. They should be managed by multidisciplinary teams, and prepregnancy counseling should not be neglected.
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Tan et al. (2006) studied this question.
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