Document Detail

Pregnancy in patients on dialysis--experience at a referral center.
MedLine Citation:
PMID:  16515231     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pregnancy is infrequent in women with end-stage renal disease. The frequency of conception in dialysis patients has been reported as 0.3% to 1.4% in different studies from different countries. In the present study the frequency and outcome of pregnancies from a referral center in Saudi Arabia from January 1992 to December 2003 is reported. METHODS: All females on maintenance hemodialysis (MHD) and chronic peritoneal dialysis (CPD) were reviewed. Files of the patients in childbearing age (less than 50 years) were analyzed for the frequency of pregnancy, mode of dialysis, complications and outcome. Of the 192 females taken for MHD and CPD, 113 were of the childbearing age. Five patients were already on HD when they became pregnant, the period on HD varied from 7-34 (mean = 24) months and in 4 dialysis was initiated during first pregnancy. (Abortion was defined as termination of pregnancy before 22 weeks of gestation. Perinatal mortality was taken as death of a viable fetus after 22 weeks of gestation or within 4 weeks after delivery. Preterm was defined as delivery before 37 weeks of gestation and low birth weight as a baby weighing less than 2500 gm at birth). RESULTS: Twelve pregnancies were noted in 9 patients (7.9%) with a yearly frequency of 0.66%. All pregnancies were noted in patients on MHD and none on CPD. Seven pregnancies (58%) ended in live births and all were preterm deliveries in the range of 27-36 (mean 31.5) weeks. All babies were low birth weight ranging from 1115-2300 (mean 1700) gram. Three deliveries were spontaneous vaginal and 4 underwent lower segment cesarean sections. Two deliveries ended in perinatal mortality. Three pregnancies ended in spontaneous abortions between 10-20 (mean 12) weeks. One woman had 3 pregnancies, the last one ending in antepartum hemorrhage, hysterotomy and hysterectomy for rupture of uterus. Another patient had 2 pregnancies. No congenital abnormalities were noted in any of the live births. CONCLUSION: Pregnancy though uncommon in women on dialysis can occur. Preterm deliveries with low birth weight are usual though live birth rate of 58% was observed. In view of the need for increased frequency of dialysis for successful outcome, planning the pregnancy and high chances of dangerous complications, early diagnosis of pregnancy in a patient on dialysis essential.
G H Malik; A Al-Harbi; S Al-Mohaya; H Dohaimi; M Kechrid; M S Shetaia; A Os Al-Hassan; Laura S Quiapos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of the Association of Physicians of India     Volume:  53     ISSN:  0004-5772     ISO Abbreviation:  J Assoc Physicians India     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-03-06     Completed Date:  2006-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505585     Medline TA:  J Assoc Physicians India     Country:  India    
Other Details:
Languages:  eng     Pagination:  937-41     Citation Subset:  IM    
Nephrology Division, Department of Internal Medicine, OB/Gyne Department, Security Forces Hospital Program, Riyadh, KSA.
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MeSH Terms
Kidney Failure, Chronic / complications,  therapy*
Middle Aged
Pregnancy Complications / etiology*
Pregnancy Outcome*
Pregnancy, High-Risk
Premature Birth*
Renal Dialysis*
Risk Assessment
Risk Factors
Saudi Arabia

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