Abstract
Objective
Evidences suggest that females with CKD are associated with high risk of maternal and fetal complications. Early referral in CKD with pregnancy for specialist care may prove useful for maternal and fetal outcome.
Methods
Study looked for assessment of impact of CKD detection at the time of pregnancy and its impact on fetal and maternal outcome.
Results
A total of 465 females were retrospectively evaluated for renal status during their pregnancies, 172 females were unaware about their renal illness at the time of pregnancy, while 208 females were under regular obstetrical and nephrological follow-up during their pregnancy. 44.1% of these females in both groups had GFR < 60 ml/min. Preeclampsia was observed in 17.6% of planned pregnancies, while it was observed in 47.5% of unplanned pregnancies. Worsening of renal failure during and following pregnancy was observed among all stages of CKD, and there was greater decline in GRF with progression to ESRD earlier during or after pregnancy among unplanned pregnancies. Planned pregnancy group had better fetal outcome. Low birth babies weighing < 2500 g in unplanned group were much higher than in planned pregnancies.
Conclusions
Chronic kidney disease is often clinically silent until renal impairment is advanced. Pregnancy can be a check point for detection of renal disease and managed appropriately for better maternal and fetal outcome.
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There is no conflict of interest between any of the authors.
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The paper is as per ethical standards approved by our own ethical committee in our institute.
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The informed consent was obtained from all the patients enrolled in the study.
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Dr Anupma Kaul, Additional Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India; Dharmendra Bhaduaria, Associate Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Mandakini Pradhan, Professor, Department of Maternal and Reproductive Health; R. K. Sharma, Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Narayan Prasad, Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; Amit Gupta, Professor, Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.
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Kaul, A., Bhaduaria, D., Pradhan, M. et al. Pregnancy Check Point for Diagnosis of CKD in Developing Countries. J Obstet Gynecol India 68, 440–446 (2018). https://doi.org/10.1007/s13224-017-1055-7
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DOI: https://doi.org/10.1007/s13224-017-1055-7