Naqvi R, Akhtar F, Ahmed E, Shaikh R, Ahmed Z, Naqvi A, Rizvi A
Sindh Institue of Urology and Transplantation Civil Hospital, Dow Medical College Karachi, Pakistan.
Ren Fail. 1996 Jul;18(4):681-3. doi: 10.3109/08860229609047694.
Although preventable, acute renal failure (ARF) of obstetrical origin continues to be common in developing countries. During the year 1994, we treated a total of 238 cases of ARE. Of these cases, 43 (18%) were of obstetrical origin. All of the patients were known to be previously healthy. Acute renal failure occurred in association with antepartum hemorrhage in 15, postpartum hemorrhage in 10, intrauterine death of fetus in 11, preeclampsia or eclampsia in 9, and septic abortions or puerperal sepsis in 7. Thirty-six patients required dialysis therapy because of moderate to severe azotemia. Renal histology was studied in 12 cases. Acute cortical necrosis was present in 9, extensive tubular necrosis in 2, and 1 patient had membranoproliferative glomerulonephritis. Twenty-two (51%) patients recovered normal renal function, while 11 (26%) developed irreversible renal dysfunction and 10 (23%) expired. Mortality and morbidity in this region is still quite high in obstetrical situations. Poor health infrastructure and lack of antenatal health clinics leads to development of major complications at the time of childbirth, which is mostly conducted at home by untrained personnel in quite a few cities of the country.
尽管可预防，但产科源性急性肾衰竭（ARF）在发展中国家仍然很常见。1994年，我们共治疗了238例急性肾衰竭病例。其中，43例（18%）为产科源性。所有患者此前均已知身体健康。急性肾衰竭与产前出血相关的有15例，产后出血相关的有10例，胎儿宫内死亡相关的有11例，先兆子痫或子痫相关的有9例，感染性流产或产褥期败血症相关的有7例。36例患者因中度至重度氮质血症需要透析治疗。对12例患者进行了肾脏组织学检查。9例存在急性皮质坏死，2例存在广泛的肾小管坏死，1例患有膜增生性肾小球肾炎。22例（51%）患者肾功能恢复正常，11例（26%）出现不可逆的肾功能障碍，10例（23%）死亡。在产科情况下，该地区的死亡率和发病率仍然相当高。卫生基础设施差和缺乏产前保健诊所导致分娩时出现重大并发症，在该国不少城市，分娩大多由未经培训的人员在家中进行。
