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Dtsch Med Wochenschr. 2019 Jan;144(1):35-38. doi: 10.1055/a-0794-8391. Epub 2019 Jan 2.

[Prenatal care in patients with renal disease].

[Article in German; Abstract available in German from the publisher]

Author information

1
Universitätsfrauenklinik Freiburg.
2
NZF-Nierenzentrum Freiburg.

Abstract

in English, German

HISTORY AND CLINICAL FINDINGS:

 We report of three pregnancies, two with renal insufficiency and one with a history of renal transplantation. Pat.1 is a 32y at 20 weeks of gestation with acute renal failure, nephrotic syndrome and history of familial Mediterranean fever. Case 2 is a 23y with cirrhotic kidneys, stage 5 of chronic kidney disease and dialysis treatment 3 × a week. The pregnancy was an incidental finding. Pat. 3 is a 29y I/0 with history of renal transplantation years ago.

DIAGNOSIS, TREATMENT AND COURSE:

 In pat. 1a renal biopsy confirmed the suspected diagnosis of AA amyloidosis. Due to deterioration of the kidney function, she required dialysis up to 6 × a week. In Case 2 the dialysis increased to 6 × a week as well. In both patients, we indicated delivery at 35 weeks of gestational age. Pat. 3 delivered at term without complications.

CONCLUSION:

 A close interdisciplinary cooperation improves neonatal outcome in pregnant women with CKD. Counseling and risk assessment of these patients should be initiated before pregnancy. The care of these high-risk pregnancies needs to be performed at a tertiary care center with the above-mentioned specialists.

PMID:
30602185
DOI:
10.1055/a-0794-8391

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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