Vázquez-Rodríguez Juan Gustavo, del Angel-García Guadalupe
Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia núm. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México, DF.
Ginecol Obstet Mex. 2010 Sep;78(9):486-92.
Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results.
To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation.
Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test.
Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case).
Frequency of perinatal complications is elevated in both groups.
接受血液透析治疗的慢性肾功能不全孕妇围产期结局不良。
比较怀孕的接受血液透析的慢性肾功能不全患者与未接受透析但在妊娠期需要透析的慢性肾功能不全女性的围产期并发症。
横向和回顾性研究，纳入3例接受慢性血液透析的慢性肾功能不全且怀孕的患者（A组）和3例受孕时未接受血液透析但在妊娠期需要透析的慢性肾功能不全患者（B组）。比较围产期结局。采用集中趋势和离散度测量以及学生t检验进行统计分析。
A组进行了25次透析，B组进行了29次血液透析（p = 0.88）。产妇并发症包括贫血100%（6例）、剖宫产83.3%（A组2例 vs. B组2例）、先兆子痫50%（A组2例 vs. B组1例）、未控制的高血压50%（A组2例 vs. B组1例）、早产50%（A组2例 vs. B组1例）、输血33.3%（A组2例）、羊水过多33.3%（A组1例 vs. B组1例）和流产16.6%（A组1例）。胎儿并发症包括胎儿丢失16.6%（A组1例）、新生儿死亡率33.3%（A组1例 vs. B组1例）、早产50%（A组2例 vs. B组1例）、胎儿窘迫50%（A组1例 vs. B组2例）、呼吸衰竭33.3%（A组2例）和胎儿生长受限16.6%（A组1例）。
两组围产期并发症发生率均升高。
