Shaw James, Katopodis Christina, Hladunewich Michelle A, Ryz Krista
Section of Nephrology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Department of Obstetrics, Gynecology and Reproductive Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Perit Dial Int. 2018 Nov-Dec;38(6):456-458. doi: 10.3747/pdi.2018.00054.
Pregnancy in patients with end-stage renal disease is rare, with a paucity of management guidelines in the literature. Various hemodialysis (HD) and peritoneal dialysis (PD) protocols have been used to successfully manage pregnancy in this population; however, there is a growing body of evidence that the best maternal and fetal outcomes are associated with intensified, high-dose HD. The optimal timing of transition from PD to HD is not known for prevalent PD patients who become pregnant. We report the case of a 32-year-old aboriginal female who became pregnant while being treated with chronic PD. She was converted to intensive HD early in the second trimester and underwent a planned caesarian section at 36 weeks with excellent outcomes for mother and child.
终末期肾病患者怀孕的情况较为罕见，文献中关于其管理指南也较少。各种血液透析（HD）和腹膜透析（PD）方案已被用于成功管理该人群的妊娠；然而，越来越多的证据表明，最佳的母婴结局与强化、高剂量血液透析相关。对于已怀孕的长期腹膜透析患者，从腹膜透析转为血液透析的最佳时机尚不清楚。我们报告了一例32岁的原住民女性病例，她在接受慢性腹膜透析治疗期间怀孕。在孕中期早期她转为强化血液透析，并在36周时接受了计划剖宫产，母婴结局良好。
