Pregnancy in women with renal disease. Yes or no?
Pregnancy and kidney disease
relatively uncommon
in 2004
was only 0.03%
prevalence of moderate chronic renal insuffiency
was 6 per 10.000 birth
several possible reasons
many women with significant renal insuffiency
beyond childbearing age or infertile
level of renal function
Stages 1 and 2
affect up to 3% of women of
child bearing age(20-39 years)
Stage 3-5
one in 150 women
of childbearing age
common complications
in pregnant women
with moderate to severe renal insuffiency
Chronic hypertension
preeclamsia
anemia
fetal growth restriction
prematurity
Chronic hypertension
predisposes women to preeclampsia
decline in renal function
Pregnancy and Dialysis
In a survey
women who began dialysis during pregnancy
The infant survival was better (73,6%)
increasing dialysis time
may improve outcome
major cause of morbidity
contributes to a high frequency of long-term medical problems
Polyhydramnios
occurs usually
between 19 and 20
weeks of gestation
is associated with peak
Pregnancy and Transplantation
provokes
lost fertility in women
occurring in 12% of women at childbearing age
Pregnancy success
rate exceeds 90%
after first trimester
It is unclear
how to best modify
immunosuppressive agents
treat rejection during pregnancy