Preface

Summary

Women with renal problems, including kidney transplant patients and those receiving dialysis, often consult clinicians on the advisability of becoming pregnant or continuing a pregnancy already in progress. Pre-existing renal disease is encountered with increasing frequency in pregnant women. When counselling and caring for such women it is crucial that the clinician understands the striking physiological alterations that occur during normal pregnancy (most marked in the renal and cardiovascular systems) as well as the need for expert multidisciplinary antenatal care with awareness of the technology for fetal surveillance and the role of neonatal intensive care. Renal problems may also arise de novo in pregnancy and again expert care is essential to ensure satisfactory short- and long-term outcomes for these women and their newborns.

This book stems from the 54th RCOG Study Group on ‘Renal Disease in Pregnancy’, which allowed specialists in many disciplines to sift the most up-to-date evidence on all aspects of diagnosis and management in women with renal problems before, during and after pregnancy. The chapters describe many of the issues likely to be faced in clinical practice, providing valuable information for all healthcare professionals working in this field.

General principles for optimal management are clearly defined and separate chapters are devoted to specific disease entities and/or clinical situations. Members of the Study Group were mindful of the need for the obstetric medicine literature to adopt the new internationally recommended five stage classification for chronic kidney disease.