Document Detail


Registry of pregnancy in dialysis patients.
MedLine Citation:
PMID:  9590185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A total of 2,299 dialysis units listed by the Health Care Finance Administration were surveyed to determine the frequency and course of pregnancies in dialysis patients. The responses included 930 units caring for 6,230 females aged 14 to 44 years (1,699 receiving peritoneal dialysis and 4,531 receiving hemodialysis). Two percent of the female patients of childbearing age became pregnant over a 4-year period (2.4% of the hemodialysis patients and 1.1% of the peritoneal dialysis patients). The infant survival rate was 40.2% in the 184 pregnancies in women who conceived after starting dialysis and 73.6% in the 57 pregnancies in women who started dialysis after conception. In the subset of women in whom dialysis modality was known, infant survival was not significantly different between the hemodialysis and peritoneal dialysis patients (39.5% v 37%). There was a trend toward better infant survival in women who received dialysis > or = 20 hours per week and a weak correlation between number of hours of dialysis and gestational age (P = 0.05). Maternal complications included two maternal deaths and five intensive care unit admissions for hypertensive crisis. Seventy-nine percent of women had some degree of hypertension, and 32 had blood pressure higher than 170/110 mm Hg. Only 5.9% of women had a hematocrit greater than 30% throughout pregnancy. Twenty-six percent of women treated with erythropoietin (EPO) and 77% of women not receiving EPO required transfusions. Eleven infants had congenital anomalies and 11 had long-term medical problems. Eighty-four percent of infants born to women who conceived after starting dialysis were premature. The likelihood of a surviving infant resulting from pregnancy in dialysis patients is higher than previously observed. There is no preferred dialysis modality. There is a suggestion that increased dialysis time may improve outcome. Prematurity remains a major cause of morbidity and likely contributes to a high frequency of long-term medical problems in surviving infants.
Authors:
I Okundaye; P Abrinko; S Hou
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  31     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-03     Completed Date:  1998-06-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  766-73     Citation Subset:  IM    
Affiliation:
Department of Medicine, Section of Nephrology, Rush Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia / etiology
Birth Weight
Congenital Abnormalities
Female
Fetal Death
Gestational Age
Humans
Hypertension / etiology
Infant Mortality
Infant, Newborn
Kidney Failure, Chronic / complications,  therapy*
Peritoneal Dialysis* / adverse effects
Peritonitis / etiology
Pregnancy
Pregnancy Complications / therapy*
Pregnancy Outcome
Registries
Renal Dialysis* / adverse effects
Comments/Corrections
Comment In:
Am J Kidney Dis. 1998 May;31(5):863-4   [PMID:  9590200 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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