The successful clinical outcomes of pregnant women with advanced chronic kidney disease
Kidney Research and Clinical Practice
; : 84-89, 2016.
Article
de En
| WPRIM
| ID: wpr-67996
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. METHODS: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary's Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications. RESULTS: There were no maternal or neonatal deaths in this cohort. The mean age at the time of conception and delivery was 35.8 ± 3.7 and 36.2 ± 3.5 years, respectively. Dialysis patients received more frequent and intensified HD during pregnancy, 20.0 ± 5.7 h/wk of HD over 5 visits with the ultrafiltration dose maintained between 1 and 2 kg per session. All patients received erythropoietin-stimulating agents and iron replacement therapy during pregnancy. The mean hematocrit was 33.1 ± 1.9% before pregnancy and was well maintained during gestation (33.9 ± 3.8% at the first trimester, 29.2 ± 4.2% at the second trimester, and 33.6 ± 8.7% at delivery). The mean gestation period was 32.7 ± 4.7 weeks, with 60% of patients experiencing premature delivery. The primary maternal complication was pre-eclampsia; 3 women developed pre-eclampsia and underwent emergency cesarean sections. Most neonatal complications were related to preterm birth. CONCLUSION: Dialysis-related care and general clinical management improved the clinical outcome of pregnancy for patients with advanced CKD.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Pré-éclampsie
/
Deuxième trimestre de grossesse
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Premier trimestre de grossesse
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Issue de la grossesse
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Ultrafiltration
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Césarienne
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Incidence
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Études de cohortes
/
Dialyse rénale
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Parturition
Type d'étude:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Female
/
Humans
/
Pregnancy
Pays comme sujet:
Asia
langue:
En
Texte intégral:
Kidney Research and Clinical Practice
Année:
2016
Type:
Article