[Pregnancy and labor in females with solitary kidney].
OBJECTIVE
To propose optimal policy of pregnancy and labor management in females with solitary kidney.


METHODS
The study included 102 pregnant women who had contracted or transplanted donor kidney, renal aplasia (17, 3 and 28 females, respectively) or had undergone nephrectomy for different diseases (n = 54). Filtration, concentration, nitrogen-eliminating renal functions, renal hemodynamics, bacteriological picture of the urine were examined. Also, ultrasonography of the kidneys, cardiotocographic monitoring, ultrasonic fetal biometry, dopplerometry of placental blood flow were made.


RESULTS
Most of the pregnant women showed declined function of the solitary kidney, but renal insufficiency was a rare finding. Pyelonephritis of the solitary kidney, on the contrary, occurred rather frequently (77.8%) causing intrauterine infection in 46% of the fetuses. Obstetric complications arose more frequently than in women with two kidneys: gestosis--28%, threatened abortion--18%, premature delivery--25%. Hypotrophy was registered in 23% of the newborns. Adequate management of pregnancy reduced stillbirth rate to only 5%. 78% of the neonates were born mature and had normal body mass.


CONCLUSIONS
Solitary kidney is not contraindication to pregnancy while pyelonephritis exacerbation--to abortion. Pregnancy is contraindicated in chronic renal failure.
Shekhtman
M M
MM
Petrova
S B
SB
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities / Q000098:blood supply / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000503:physiopathology / Q000601:surgery* / Q000652:urine; D007743:Labor, Obstetric / Q000502:physiology*; D008991:Monitoring, Physiologic; D009392:Nephrectomy; D010920:Placenta / Q000098:blood supply; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine; D011256:Pregnancy Outcome; D012079:Renal Circulation; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal