Embarazo en hemodiálisis crónica: experiencia de un hospital universitario

Background: Pregnancies in women with end stage renal failure are uncommon. However, correction of anemia and improvement in dialysis techniques increases the rate of successful pregnancies. Aim: To describe a 16 years’ experience treating pregnant women on hemodialysis and to analyze ma...

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Autores principales:	Fiedler Z.,Úrsula, Sanhueza V.,MA. Eugenia, Toro C.,Luis
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2019
Materias:	Kidney Failure, Chronic Pregnancy Renal Dialysis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000600709
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spelling	oai:scielo:S0034-988720190006007092019-08-28Embarazo en hemodiálisis crónica: experiencia de un hospital universitarioFiedler Z.,ÚrsulaSanhueza V.,MA. EugeniaToro C.,Luis Kidney Failure, Chronic Pregnancy Renal Dialysis Background: Pregnancies in women with end stage renal failure are uncommon. However, correction of anemia and improvement in dialysis techniques increases the rate of successful pregnancies. Aim: To describe a 16 years’ experience treating pregnant women on hemodialysis and to analyze maternal-fetal outcomes. Materials and Methods: Observational study of a dialysis center historical cohort in a university hospital, between 2001 and 2016. Results: Thirteen pregnancies were found in 11 women aged 23 to 32 years, 77% on dialysis prior to pregnancy. Residual diuresis was 1,300 [625-1,575] mL in 24 hrs. The baseline hemoglobin was 9.0 [7.6-9.9] g/dL and 92% of patients did not use contraception. The pre-dialysis blood urea nitrogen was 34 [29-36] mg /dL. An ultrasound to confirm pregnancy was done in all. At 23 [14-25] weeks of pregnancy, dialysis hours were increased, reaching 24 [19.5-24.0] hours per week. The most common complications were severe arterial hypertension (54%), severe anemia (46%), polyhydramnios (31%) and severe intrauterine growth retardation (IUGR) (23%). The median time of pregnancy at delivery was 34 [29-34] weeks. Neonatal median hospitalization length was 4 [4-32] days, with 18% of neonatal deaths. Conclusions: Pregnancies in dialysis are no longer exceptional. Despite better maternal and fetal outcomes, morbidity and mortality remains higher than in the normal population, which makes multidisciplinary management essential.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.147 n.6 20192019-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000600709es10.4067/S0034-98872019000600709
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Kidney Failure, Chronic Pregnancy Renal Dialysis
spellingShingle	Kidney Failure, Chronic Pregnancy Renal Dialysis Fiedler Z.,Úrsula Sanhueza V.,MA. Eugenia Toro C.,Luis Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
description	Background: Pregnancies in women with end stage renal failure are uncommon. However, correction of anemia and improvement in dialysis techniques increases the rate of successful pregnancies. Aim: To describe a 16 years’ experience treating pregnant women on hemodialysis and to analyze maternal-fetal outcomes. Materials and Methods: Observational study of a dialysis center historical cohort in a university hospital, between 2001 and 2016. Results: Thirteen pregnancies were found in 11 women aged 23 to 32 years, 77% on dialysis prior to pregnancy. Residual diuresis was 1,300 [625-1,575] mL in 24 hrs. The baseline hemoglobin was 9.0 [7.6-9.9] g/dL and 92% of patients did not use contraception. The pre-dialysis blood urea nitrogen was 34 [29-36] mg /dL. An ultrasound to confirm pregnancy was done in all. At 23 [14-25] weeks of pregnancy, dialysis hours were increased, reaching 24 [19.5-24.0] hours per week. The most common complications were severe arterial hypertension (54%), severe anemia (46%), polyhydramnios (31%) and severe intrauterine growth retardation (IUGR) (23%). The median time of pregnancy at delivery was 34 [29-34] weeks. Neonatal median hospitalization length was 4 [4-32] days, with 18% of neonatal deaths. Conclusions: Pregnancies in dialysis are no longer exceptional. Despite better maternal and fetal outcomes, morbidity and mortality remains higher than in the normal population, which makes multidisciplinary management essential.
author	Fiedler Z.,Úrsula Sanhueza V.,MA. Eugenia Toro C.,Luis
author_facet	Fiedler Z.,Úrsula Sanhueza V.,MA. Eugenia Toro C.,Luis
author_sort	Fiedler Z.,Úrsula
title	Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
title_short	Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
title_full	Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
title_fullStr	Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
title_full_unstemmed	Embarazo en hemodiálisis crónica: experiencia de un hospital universitario
title_sort	embarazo en hemodiálisis crónica: experiencia de un hospital universitario
publisher	Sociedad Médica de Santiago
publishDate	2019
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000600709
work_keys_str_mv	AT fiedlerzursula embarazoenhemodialisiscronicaexperienciadeunhospitaluniversitario AT sanhuezavmaeugenia embarazoenhemodialisiscronicaexperienciadeunhospitaluniversitario AT torocluis embarazoenhemodialisiscronicaexperienciadeunhospitaluniversitario
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Embarazo en hemodiálisis crónica: experiencia de un hospital universitario

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