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Acute renal failure in pregnancy

J E Ventura1, M Villa, R Mizraji

  • 1Centro de Nefrología, Hospital de Clinicas, Universidad de la Republica, Montevideo, Uruguay.

Renal Failure
|March 1, 1997
PubMed
Summary

Obstetric acute renal failure (ARF) in pregnant women was mainly caused by hypertensive disorders and acute pyelonephritis. While maternal mortality was low, perinatal mortality remained high.

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Area of Science:

  • Nephrology
  • Obstetrics
  • Perinatology

Background:

  • Obstetric acute renal failure (ARF) presents a significant clinical challenge.
  • Hypertensive disorders and infections are common causes of ARF during pregnancy.

Purpose of the Study:

  • To analyze the causes, outcomes, and mortality associated with obstetric acute renal failure (ARF).
  • To evaluate maternal and perinatal mortality in patients with ARF during pregnancy.

Main Methods:

  • Retrospective review of 57 women with obstetric ARF from 1976 to 1994.
  • Categorization of ARF causes including preeclampsia, acute pyelonephritis, and idiopathic postpartum renal failure.

Main Results:

  • Hypertensive disorders (preeclampsia) and acute pyelonephritis accounted for over 50% of ARF cases.
  • Maternal mortality was low (<2%), but perinatal mortality was high (40%).
  • Chronic renal failure developed in 6 patients, with causes including bilateral renal cortical necrosis.

Conclusions:

  • Obstetric ARF, primarily due to hypertensive disorders and pyelonephritis, has a low maternal mortality rate.
  • High perinatal mortality underscores the severity of obstetric ARF for neonates.
  • Prompt management of hypertensive disorders and infections is crucial in pregnancy to mitigate ARF risks.

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