Villa G, Montagna G, Segagni S
Divisione di Nefrologia ed Emodialisi, Fondazione Salvatore Maugeri IRCCS, Centro Medico, Pavia.
G Ital Nefrol. 2007 Mar-Apr;24(2):132-40.
A case report of a pregnancy in a patient with end-stage renal disease on chronic dialysis is presented. The epidemiological data regarding this rare event and the factors influencing and limiting fertility in uremic women are discussed. The outcomes of pregnancy in dialysis as reported in national registries and literature series are analyzed. For the management of pregnancy in dialysis several practical problems have to be dealt with: the type of dialysis, sterilization of dialysis materials, dialysis dose, dialysis bath composition, extracorporeal circuit anticoagulation, and the diet of the pregnant woman. All these issues are discussed, with special attention to solutions facilitating the best outcome of pregnancy. Finally, the main complications of both normal and uremic pregnancies, anemia and hypertension, are discussed together with the solutions proposed in this particular condition.
本文报告了一例终末期肾病患者在接受慢性透析期间怀孕的病例。讨论了有关这一罕见事件的流行病学数据以及影响和限制限制限制尿毒症女性生育能力的因素。分析了国家登记处和文献系列中报道的透析患者怀孕结局。对于透析患者怀孕的管理,必须处理几个实际问题:透析类型、透析材料的消毒、透析剂量、透析液成分、体外循环抗凝以及孕妇的饮食。对所有这些问题进行了讨论,并特别关注有助于实现最佳妊娠结局的解决方案。最后,讨论了正常妊娠和尿毒症妊娠的主要并发症——贫血和高血压,以及针对这种特殊情况提出的解决方案。