Successful pregnancy in a patient on regular hemodialysis awaiting kidney transplantation

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Abstract

Currently, the prevalence of chronic kidney disease in the general population is in the range of 8.7 to 18.4%, being at least 3% in women of childbearing age. Therefore, improvement of pregnancy outcomes in patients with chronic kidney disease is an important medical and social problem. In the past, pregnancy in women receiving the program hemodialysis (HD) was considered impossible. The first successful pregnancy in HD was described in 1971. Recently, pregnancy outcomes in dialysis patients significantly improved with an increase in the live births to 73–79%. It was shown that intensification of the dialysis program plays an important role in the achievement of a  favorable pregnancy outcome, with an increase in the number of sessions to 6 weekly, and the total weekly duration of dialysis of up to 24 hours and more. We present a  clinical case of a  favorable course of pregnancy that was eventually detected in a  patient on program HD during her examination before the kidney transplantation. Her dialysis program was intensified, with no subsequent complications characteristic of pregnancy in chronic kidney disease, such as hypertension, preeclampsia, severe anemia, and serious fetal growth retardation syndrome. At week 38 of gestation, programmed vaginal delivery was performed; a healthy girl was born who did not need any intensive care. The successful outcome of this pregnancy was due to intensive dialysis treatment, a multidisciplinary approach to pregnancy management, and thorough obstetric monitoring.

About the authors

E. I. Prokopenko

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: renalnephron@gmail.com

MD, PhD, Professor, Chair of Transplantology, Nephrology and Artificial Organs, Postgraduate Training Faculty

61/2–6 Shchepkina ul., Moscow, 129110

Tel.: +7 (495) 684 57 91

Россия

I. G. Nikol'skaya

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

MD, PhD, Scientific Secretary

22а Pokrovka ul., Moscow, 101000

Россия

O. B. Rybakova

LLC “Medical Center of High Technologies”– Polyclinic No 1

Email: fake@neicon.ru

MD, PhD, Chief Medical Officer

3/1 Rodionovskaya ul., Moscow, 141411

Россия

S. V. Novikova

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

MD, PhD, Head of Observational Obstetric Department

22а Pokrovka ul., Moscow, 101000

Россия

E. Yu. Upriamova

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

MD, PhD, Head of Department of Anaesthesiology and Intensive Care

22а Pokrovka ul., Moscow, 101000

Россия

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Copyright (c) 2017 Prokopenko E.I., Nikol'skaya I.G., Rybakova O.B., Novikova S.V., Upriamova E.Y.

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