Obstetric outcomes in women with end-stage renal failure requiring renal dialysis

ObjectiveTo study obstetric outcomes in women with end-stage renal failure undergoing chronic renal dialysis. Methods: A retrospective review of the database from the High-Risk Pregnancy Clinic at Singapore General Hospital, Singapore. Results: From 1995 to 2004, 7 women treated with chronic renal dialysis had a total of 11 pregnancies. There were 2 pregnancy losses at previable gestation ages and 9 live births. Median gestational age at delivery was 31 weeks, and mean birth weight was 1390 g. Seven newborns had a low birth weight and 5 required neonatal intensive care. Severe hypertension occurred in 4 women for a total of 7 pregnancies. Other complications included polyhydramnios (n = 2), preterm prelabor rupture of membranes (n = 2), obstetric cholestasis (n = 2), postpartum hemorrhage (n = 1), thrombosis of the arteriovenous fistula (n = 2), postpartum peritonitis (n = 1), and fetal anomaly (n = 1). There were no maternal deaths. Conclusion: Such pregnancies are high-risk, particularly because of maternal hypertension and prematurity. They should be managed by multidisciplinary teams, and prepregnancy counseling should not be neglected.