Key result
Epidural anesthesia was safely performed for cesarean section in two parturients with chronic renal failure undergoing heparin-free hemodialysis, with stable maternal hemodynamics and healthy newborns.
Why the study?
Pregnancies requiring hemodialysis carry high maternal and fetal mortality and morbidity, prompting the need to develop reasonable anesthetic methods and management objectives for cesarean delivery in this population.
Does epidural anesthesia provide safe outcomes in parturients with chronic renal failure requiring hemodialysis undergoing cesarean section?
Case Report (n=2)
No
Does epidural anesthesia provide safe outcomes in parturients with chronic renal failure requiring hemodialysis undergoing cesarean section?
Epidural anesthesia can be safely performed for cesarean section in parturients with chronic renal failure undergoing heparin-free hemodialysis, provided coagulation function is normal.
Case reports of hemodialysis pregnancies warrant cautious individualized counseling; leaves open need for prospective data on outcomes and management.
Pregnancies are rare in women with chronic renal failure requiring hemodialysis. Although a chance of successful pregnancy and delivery in hemodialysis women has increased over the years, it is still very low, and with high maternal and fetal mortality and morbidity rate compared to normal population. And cesarean section is usually used for delivery. The first case was a 32-year-old Chinese woman with chronic kidney disease stage V undergoing maintenance hemodialysis for six years. The second case was also a 32-year-old patient with a 6-year history of hemodialysis for chronic glomerulonephritis. And due to a history of atrial septal defect and hypertension she received intensive hemodialysis during pregnancy. Both cases were scheduled for cesarean delivery under epidural anesthesia. To help develop reasonable anesthetic methods and management objectives for such patients, we described our anesthetic management and performed a literature search on published cases of cesarean section with chronic renal failure undergoing hemodialysis.
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Zhang et al. (2022) conducted a case report in Chronic renal failure requiring hemodialysis in pregnancy (n=2). Epidural anesthesia was evaluated on Maternal and fetal safety and outcomes. Epidural anesthesia was safely performed for cesarean section in two parturients with chronic renal failure undergoing heparin-free hemodialysis, with stable maternal hemodynamics and healthy newborns.
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