Pregnancy on intensified hemodialysis: fetal surveillance and perinatal outcome.
OBJECTIVE
To evaluate the effect of intensive fetal surveillance via Doppler ultrasound and fetal non-stress test on the perinatal outcome of pregnant women undergoing an intensified hemofiltration scheme.


METHODS
Five consecutive pregnancies of women undergoing intensified hemodialysis were analyzed due to the following parameters: maternal background, hemodialysis schedule during pregnancy, blood pressure, occurrence of fetal complications, occurrence of obstetric complications, gestational week at delivery, mode of delivery, and newborn outcome and follow-up.


RESULTS
All pregnancies resulted in a live birth, mean gestational age was 32 weeks. Intrauterine growth restriction occurred in 4 fetuses, pathological umbilical artery flow velocity waveforms in 2. The mean birth weight was 1,764 g (range 1,274-2,465 g). Cesarean section was performed in 3 patients because of fetal distress. None of the patients developed severe complications like pre-eclampsia.


CONCLUSIONS
Although intensified dialysis enables the maintenance of stable uteroplacental and fetal perfusion, intensive fetal monitoring is mandatory to reduce perinatal morbidity and mortality in pregnant women on maintenance dialysis.
Bamberg
Christian
C
Department of Obstetrics and Gynecology, Charité University Hospital, Campus Mitte, Berlin, Germany.
Diekmann
Fritz
F
Haase
Michael
M
Budde
Klemens
K
Hocher
Berthold
B
Halle
Horst
H
Hartung
John
J
D000328:Adult; D001724:Birth Weight; D001783:Blood Flow Velocity; D015148:Cardiotocography; D002675:Child, Preschool; D005260:Female; D005316:Fetal Distress / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D017078:Laser-Doppler Flowmetry; D050498:Live Birth; D021041:Placental Circulation; D006831:Polyhydramnios / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors; D016216:Ultrasonography, Prenatal