Pregnancy in End-stage Renal Disease Patients on Long-term Hemodialysis: Two Case Reports
Journal
BANTAO Journal
Date Issued
2010
Author(s)
Tozija, Liljana
Gelev, Saso
Adamova, Gordana
Abstract
Although still uncommon, pregnancy in haemodialysis (HD)
patients does occur and frequency has been increased in
the past 20 years. But unfortunately, the rates for premature
delivery, neonatal death, maternal hypertension, and
preeclampsia in the pregnant HD patient are much higher
than in the general population. Infants are often born both
prematurely and small for gestational age. We report here
two cases of pregnancy in women on long-term HD, one
successfully and the other unsuccessfully managed, despite
the same treatment strategy. Case 1 was a 43-year-old
female patient, 10th gravida, after six years of maintenance
HD whose pregnancy was successfully managed up to the
33rd week of gestation with a delivery of a healthy boy weighing
2,100 g. Case 2 was a 32-year-old female patient, 2nd
gravida, after five years of maintenance HD, whose pregnancy
ended in spontaneous abortion with intrauterine death
at week 19 of gestation. Maternal hypertension and anemia
contributed partly to the unsuccessful outcome.
A successful pregnancy in HD patients requires multidisciplinary
management, but considering the previous nephrological/
prenatal/gynaecological/obstetric recommendations,
many open questions remain when it comes to the best
treatment and management of pregnancy in these women.
patients does occur and frequency has been increased in
the past 20 years. But unfortunately, the rates for premature
delivery, neonatal death, maternal hypertension, and
preeclampsia in the pregnant HD patient are much higher
than in the general population. Infants are often born both
prematurely and small for gestational age. We report here
two cases of pregnancy in women on long-term HD, one
successfully and the other unsuccessfully managed, despite
the same treatment strategy. Case 1 was a 43-year-old
female patient, 10th gravida, after six years of maintenance
HD whose pregnancy was successfully managed up to the
33rd week of gestation with a delivery of a healthy boy weighing
2,100 g. Case 2 was a 32-year-old female patient, 2nd
gravida, after five years of maintenance HD, whose pregnancy
ended in spontaneous abortion with intrauterine death
at week 19 of gestation. Maternal hypertension and anemia
contributed partly to the unsuccessful outcome.
A successful pregnancy in HD patients requires multidisciplinary
management, but considering the previous nephrological/
prenatal/gynaecological/obstetric recommendations,
many open questions remain when it comes to the best
treatment and management of pregnancy in these women.