Maternal and Fetal Outcomes and Their Predictors in Renal Dysfunction in Pregnancy

Area of Science:

• Nephrology
• Obstetrics & Gynecology
• Critical Care Medicine

Background:

• Renal disorders in pregnancy, encompassing acute kidney injury (AKI) and chronic kidney disease (CKD), present substantial risks to both maternal and fetal well-being.
• These conditions necessitate a thorough understanding of their epidemiology and clinical outcomes within a specialized healthcare setting.

Purpose of the Study:

• To investigate the epidemiology and outcomes of pregnancy-related AKI and CKD.
• To analyze maternal and fetal outcomes in pregnant women with these renal conditions.

Main Methods:

• A retrospective study was conducted at a tertiary care center.
• Inclusion criteria comprised pregnant women and those up to 6 weeks postpartum diagnosed with AKI or CKD, excluding individuals under 18.
• Data collected included maternal demographics, gestational age, causes of renal injury, treatment interventions, and maternal/fetal outcomes.

Main Results:

• Out of 70 cases, 55 had AKI, 10 had both AKI and CKD, and 5 had CKD. Sepsis and pre-eclampsia were leading causes of AKI.
• Maternal mortality was 14.7% (10/68), with 48 mothers recovering fully. Hemodialysis was required by 20 patients, resulting in 6 deaths.
• Fetal outcomes were poor, with 35 fetal deaths. Maternal factors like hypertension, sepsis, metabolic acidosis, elevated bilirubin, and need for hemodialysis correlated with adverse maternal outcomes. Elevated bilirubin was linked to poor fetal outcomes.

Conclusions:

• Pregnancy-associated AKI and CKD are linked to significant maternal and fetal morbidity and mortality.
• Emphasis on prevention through regular antenatal checkups is vital for mitigating these risks.