Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Port Road, Adelaide, South Australia, 5000, Australia; Department of Medicine, University of Adelaide, Adelaide, South Australia, 5000, Australia.
Sydney School of Public Health, The University of Sydney, New South Wales, 2006, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, 2145, Australia.
Best Pract Res Clin Obstet Gynaecol. 2019 May;57:77-88. doi: 10.1016/j.bpobgyn.2018.12.003. Epub 2018 Dec 12.
Achieving parenthood is often a priority and goal for women with chronic kidney disease (CKD). It can be challenging due to medical and emotional complexities around pregnancy planning and care, increased risk of adverse maternal and fetal outcomes, fears about medications such as immunosuppressants and fetal harm, and concerns regarding the impact of pregnancy on women's kidney health. Navigating the pathways for shared decision-making regarding parenthood requires an understanding of the patient's experiences, values, priorities, and needs. In this review, we describe the patient perspective of high-risk pregnancies including those complicated by CKD and outline recommendations for counseling that incorporate these perspectives to improve the patient experience.
对于患有慢性肾脏病（CKD）的女性来说，实现为人父母的愿望往往是重中之重和目标。由于妊娠规划和护理方面存在医学和情感方面的复杂性、母婴不良结局风险增加、对免疫抑制剂等药物和胎儿损害的担忧、以及对妊娠对女性肾脏健康影响的担忧，这可能具有挑战性。要了解患者的经历、价值观、优先事项和需求，才能找到有关生育问题的共同决策的途径。在这篇综述中，我们描述了包括 CKD 在内的高危妊娠的患者观点，并概述了纳入这些观点以改善患者体验的咨询建议。
