Obstetric outcomes in women with end-stage renal failure requiring renal dialysis.
OBJECTIVE
To study obstetric outcomes in women with end-stage renal failure undergoing chronic renal dialysis.


METHODS
A retrospective review of the database from the High-Risk Pregnancy Clinic at Singapore General Hospital, Singapore.


RESULTS
From 1995 to 2004, 7 women treated with chronic renal dialysis had a total of 11 pregnancies. There were 2 pregnancy losses at previable gestation ages and 9 live births. Median gestational age at delivery was 31 weeks, and mean birth weight was 1390 g. Seven newborns had a low birth weight and 5 required neonatal intensive care. Severe hypertension occurred in 4 women for a total of 7 pregnancies. Other complications included polyhydramnios (n=2), preterm prelabor rupture of membranes (n=2), obstetric cholestasis (n=2), postpartum hemorrhage (n=1), thrombosis of the arteriovenous fistula (n=2), postpartum peritonitis (n=1), and fetal anomaly (n=1). There were no maternal deaths.


CONCLUSIONS
Such pregnancies are high-risk, particularly because of maternal hypertension and prematurity. They should be managed by multidisciplinary teams, and prepregnancy counseling should not be neglected.
Tan
L-K
LK
Department of Obstetrics and Gynecology, Singapore General Hospital, Singapore. aetlk@yahoo.com
Kanagalingam
D
D
Tan
H-K
HK
Choong
H-L
HL
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology* / Q000628:therapy; D011256:Pregnancy Outcome; D006435:Renal Dialysis; D012189:Retrospective Studies