title: Pregnancy in women undergoing hemodialysis: case series in a Southeast Brazilian reference center.
abstract: OBJECTIVE
  To describe maternal and neonatal outcomes in pregnant women undergoing hemodialysis in a referral center in Brazilian Southeast side.
  
  
  METHODS
  Retrospective and descriptive study, with chart review of all pregnancies undergoing hemodialysis that were followed-up at an outpatient clinic of high- risk prenatal care in Southeast Brazil.
  
  
  RESULTS
  Among the 16 women identified, 2 were excluded due to follow-up loss. In 14 women described, hypertension was the most frequent cause of chronic renal failure (half of cases). The majority (71.4%) had performed hemodialysis treatment for more than one year and all of them underwent 5 to 6 hemodialysis sessions per week. Eleven participants had chronic hypertension, 1 of which was also diabetic, and 6 of them were smokers. Regarding pregnancy complications, 1 of the hypertensive women developed malignant hypertension (with fetal growth restriction and preterm delivery at 29 weeks), 2 had acute pulmonary edema and 2 had abruption placenta. The mode of delivery was cesarean section in 9 women (64.3%). All neonates had Apgar score at five minutes above 7.
  
  
  CONCLUSIONS
  To improve perinatal and maternal outcomes of women undergoing hemodialysis, it is important to ensure multidisciplinary approach in referral center, strict control of serum urea, hemoglobin and maternal blood pressure, as well as close monitoring of fetal well-being and maternal morbidities. Another important strategy is suitable guidance for contraception in these women.
authors.affiliation: Tocogynecology Residence Program, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
authors.forename: Maria Beatriz Bracco
authors.initials: MB
authors.lastname: Suarez
authors.affiliation: Department of Tocogynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Costa
authors.affiliation: Department of Tocogynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
authors.forename: Mary Ângela
authors.initials: MÂ
authors.lastname: Parpinelli
authors.affiliation: Department of Tocogynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
authors.forename: Fernanda Garanhani
authors.initials: FG
authors.lastname: Surita
mesh_terms: D000328:Adult; D001938:Brazil; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D006435:Renal Dialysis; D012189:Retrospective Studies