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Chapter 48 - Dialysis in Pregnancy

from Section 7 - Hepato-Renal and Gastrointestinal Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Tiina Podymow ,
Amira El-Messidi  and
Michelle Hladunewich
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 33-year-old primigravida on thrice weekly hemodialysis while awaiting renal transplantation is referred by her nephrologist to your high-risk obstetric unit. Given irregular menstrual cycles, she did a home urine pregnancy test after three months of amenorrhea. Yesterday, she was pleasantly surprised with dating sonography confirming a single viable intrauterine fetus at 11+1 weeks’ gestation. The request for consultation ensures that her nephrologist, nutritionist, and other allied members in dialysis care will follow her pregnancy with you.

Keywords

Hemodialysis, pregnancyComorbiditiesInvestigations, prenatalFetal aneuploidy screening with dialysisPharmacology, treatment, sevelamer, atenolol, angiotensin-converting enzyme inhibitor (ACEi), indomethacinPreeclampsiaPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeAntepartum, intrapartum, postpartum managementContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 605 - 616
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Cabiddu, G, Castellino, S, Gernone, G, et al. Best practices on pregnancy on dialysis: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2015;28(3):279–288.CrossRefGoogle Scholar
Hladunewich, MA, Hou, S, Odutayo, A, et al. Intensive hemodialysis associates with improved pregnancy outcomes: a Canadian and United States cohort comparison. J Am Soc Nephrol. 2014;25(5):1103–1109.CrossRefGoogle ScholarPubMed
Hoffman, M, Sibai, B. Dialysis in pregnancy: role of the underlying cause of renal failure on peripartum outcomes. Am J Perinatol. 2020;37(6):570–576.Google ScholarPubMed
Piccoli, GB, Minelli, F, Versino, E, et al. Pregnancy in dialysis patients in the new millennium: a systematic review and meta-regression analysis correlating dialysis schedules and pregnancy outcomes. Nephrol Dial Transplant. 2016;31(11):1915–1934.CrossRefGoogle ScholarPubMed
Tangren, J, Nadel, M, Hladunewich, MA. Pregnancy and end-stage renal disease. Blood Purif. 2018;45(1–3):194–200.CrossRefGoogle ScholarPubMed
Wiles, K, Chappell, L, Clark, K, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol. 2019;20(1):401.CrossRefGoogle ScholarPubMed
Wiles, K, de Oliveira, L. Dialysis in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2019; 57:33–46.CrossRefGoogle ScholarPubMed

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