Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Adv Chronic Kidney Dis. 2013 May;20(3):246-52. doi: 10.1053/j.ackd.2013.01.010.
Pregnancy in patients with ESRD is rare and remains especially challenging. Because endocrine abnormalities and sexual dysfunction decrease fertility, conception rates have been remarkably low in this patient population. Moreover, when pregnancy does occur, hypertension, preeclampsia, anemia, intrauterine growth restriction, preterm delivery, stillbirth, and other complications can decrease the rate of a successful outcome. However, recent experiences with intensive hemodialysis managed by a multidisciplinary team are encouraging with respect to better overall outcomes for mothers and infants. In this article, we discuss the main causes of decreased fertility in dialysis-dependent women, review outcomes and complications of pregnancy among dialysis patients with a special focus on recent intensive hemodialysis data, and summarize the current best strategy to manage pregnant women on dialysis.
终末期肾病患者的妊娠较为罕见，且极具挑战性。由于内分泌异常和性功能障碍会降低生育能力，因此该患者人群的受孕率极低。此外，即便妊娠确实发生，高血压、子痫前期、贫血、宫内生长受限、早产、死胎和其他并发症也会降低妊娠结局的成功率。然而，最近多学科团队管理的强化血液透析的经验令人鼓舞，这对于母婴的整体预后更好。在本文中，我们讨论了导致透析依赖女性生育力下降的主要原因，回顾了透析患者妊娠的结局和并发症，特别关注了最近强化血液透析的数据，并总结了目前管理透析孕妇的最佳策略。
