Gupta Amrit, Dubey Kalika, Sharma Gargi, Gupta Ruchi
Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
J Obstet Gynaecol India. 2022 Jun;72(3):201-207. doi: 10.1007/s13224-021-01427-8. Epub 2021 Jun 23.
Renal disease has always been a challenge for the treating obstetrician. With new advances in the management of renal disease, an increasing number of patients can continue the pregnancy and with individualization have a better outcome.
To analyze the pregnancy outcomes in renal disease, a retrospective cohort observational study over 5 years at a tertiary care institute in northern India was done. All the pregnant women with pre-existing renal disease of any etiology presenting at any period of gestation who consented were included and those not consenting were excluded from the study.
Of 62 patients enrolled, 82.26% ( = 51) were followed,17.74%( = 11) were lost to follow up. 58.82% ( = 30) had to undergo termination of pregnancy and 41.18%( = 21) had delivery after 28 weeks of gestation. The antenatal complications seen were hypertension in 15.69%, diabetes mellitus in 9.80%, anemia in 5.88%. Fetal complications included preterm delivery (42.85%) and small for gestational age babies(61.90%). Cesarean delivery was 85.71% and normal delivery in 14.29% of patients.
Both maternal and fetal outcomes are influenced by the cause and degree of renal dysfunction. A better outcome is seen when the renal disease is under control, good antenatal follow-up, multidisciplinary approach, and timely delivery.
肾脏疾病一直是产科医生治疗中的一项挑战。随着肾脏疾病管理方面的新进展，越来越多的患者能够继续妊娠，并且通过个体化治疗可获得更好的结局。
为分析肾脏疾病患者的妊娠结局，在印度北部一家三级医疗机构进行了一项为期5年的回顾性队列观察研究。纳入所有在任何孕周出现的、病因各异的、已存在肾脏疾病且同意参与的孕妇，不同意者被排除在研究之外。
在纳入的62例患者中，82.26%（n = 51）得到随访，17.74%（n = 11）失访。58.82%（n = 30）不得不终止妊娠，41.18%（n = 21）在妊娠28周后分娩。产前并发症包括高血压（15.69%）、糖尿病（9.80%）、贫血（5.88%）。胎儿并发症包括早产（42.85%）和小于胎龄儿（61.90%）。剖宫产率为85.71%，顺产率为14.29%。
孕产妇和胎儿的结局均受肾功能障碍的病因和程度影响。当肾脏疾病得到控制、进行良好的产前随访、采取多学科方法并适时分娩时，可以获得更好的结局。
