A successful pregnancy and parturition in a patient with anuria undergoing maintenance hemodialysis for 6 years: a case report of a 3-year-follow-up

Pregnancies in hemodialysis patients are uncommon and difficult to study. Although the chance of a successful pregnancy and parturition in hemodialysis women has increased over the years, it still remains extremely low with a high maternal and fetal mortality and morbidity rate.

We reported a case of successful pregnancy and parturition in a 22-year-old Chinese female in uremic stage of chronic renal failure and undergoing maintenance hemodialysis (three sessions a week) for 6 years. At the 22nd gestational week, she was diagnosed as pregnant by ultrasound, and started an enhanced hemodialysis routine (Five sessions a week). At the 32nd gestational week, she got hospitalized and received hemodialysis more frequently (seven sessions a week). Based on the initial diagnoses, including uremic stage of chronic renal failure, stage-3 hypertension, single pregnancy of 32nd gestational week, single umbilical artery and polyhydramnios, a drug therapy consisting of compound amino acid, fructosediphosphate sodium, 10 % L-carnitine, erythropoietin, polyferose, amlodipine, isosorbidedinitrate, low-molecular weight-heparin, multivitamins and folic acid was given, and daily examination of the mother and fetus was performed. Under the joint efforts of various departments, the patient underwent caesarean section at the 34th gestational week due to progressive uterine contraction and gave birth to a female, well-being baby weighing 1470 g. It has been more than 3 years since the parturition. The mother has returned to the previous hemodialysis routine, and the child has been growing up healthily.

Although pregnancy in hemodialysis patients is rare, with a high rate of risks. Patients could still gain a good outcome, if we intensify hemodialysis and enhance the collaboration between the patient, nephrologists, obstetricians, neonatologist, nutritionists, and other departments.