Acute renal failure in pregnancy at a tertiary level hospital in Mumbai: An epidemiological profile.

ABSTRACT

Background: To study the clinical profile of pregnancy related acute renal failure, management and outcome in terms of cure, maternal morbidity and maternal – fetal mortality. Methods: This is a prospective observational study carried out on hospitalized patients in our hospital over a period of fourteen months (August 2007 – September 2008) after approval from the ethical clearance committee. Results: A total of 41 patients, with age ranging between 15 – 45 years. The majority of the patients 25 (60.98%) were multigravida and 16 (39.02%) were primigravida. The bimodal frequency pattern were also observed in our study, first between 19 to 24 weeks of gestation and second around 31 to 36 weeks of gestation. The incidence of PR-ARF was about 1 in 270 pregnancies. Sepsis was the commonest cause of PR-ARF (46.34 %) followed by Toxaemia of Pregnancy (31.69%) and Haemorrhage (14.62%). The incidence of septic abortion as a cause of PR-ARF has declined to 7.31%. Oliguria was the commonest symptom (58.53%). Fluid overload was the most common complication encountered (33.33%). Conclusion: Incidence of PR-ARF is still high in our country as compared to western countries. Multigravidas were more commonly affected than primigravidas. Sepsis was the commonest cause of PR-ARF followed by toxaemia of pregnancy and haemorrhage. Maternal and fetal mortality were high , 17.07 % and 2.43 % respectively.