Ghosh Angan, Ninave Sanjot
Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 7;16(8):e66389. doi: 10.7759/cureus.66389. eCollection 2024 Aug.
Chronic kidney disease (CKD) presents significant challenges in the management of pregnant women due to its impact on renal function and cardiovascular stability. This review examines the crucial role of anesthesia management in antenatal care for women with CKD, focusing on the complexities introduced by renal dysfunction and the implications for maternal and fetal health outcomes. The review discusses the physiological changes in CKD during pregnancy, highlighting the increased risks of hypertension, proteinuria, and adverse fetal outcomes. Anesthesia considerations, including the choice of anesthesia techniques (general anesthesia, regional anesthesia), perioperative monitoring, and management of fluid and electrolyte balance, are analyzed in the context of CKD-specific challenges. Clinical outcomes and current evidence regarding anesthesia efficacy and safety in CKD patients are reviewed, emphasizing the need for tailored anesthesia protocols to ensure optimal maternal comfort and fetal safety. The review concludes by identifying research gaps and proposing future directions to enhance anesthesia practices and improve outcomes for pregnant women with CKD undergoing surgical interventions or labor management.
慢性肾脏病(CKD)对孕妇的肾功能和心血管稳定性产生影响,给孕妇管理带来了重大挑战。本综述探讨了麻醉管理在CKD孕妇产前护理中的关键作用,重点关注肾功能不全带来的复杂性及其对母婴健康结局的影响。该综述讨论了孕期CKD的生理变化,强调了高血压、蛋白尿和不良胎儿结局风险增加的情况。在CKD特定挑战的背景下,分析了麻醉相关考虑因素,包括麻醉技术的选择(全身麻醉、区域麻醉)、围手术期监测以及液体和电解质平衡的管理。回顾了CKD患者麻醉疗效和安全性的临床结局及现有证据,强调需要制定个性化麻醉方案以确保产妇舒适和胎儿安全达到最佳状态。综述最后指出了研究空白,并提出了未来方向,以加强麻醉实践并改善接受手术干预或分娩管理的CKD孕妇的结局。