Gravidez na doença renal crónica: da diálise peritoneal à hemodiálise

• Autor(a) principal: Pinto,Pedro Viana
• Data de Publicação: 2016
• Outros Autores: Nunes,Ana Teresa, Santos,Carla, Martins,Patricia, Machado,Ana Paula, Montenegro,Nuno
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302016000300003
• topic: Pregnancy; Hemodialysis; Chronic Kidney Disease; Peritoneal Dialysis

Overview and Aims: pregnancy in women with chronic kidney disease (CKD), particularly in terminal CKD, remains a rare event. There are scarce reports of pregnancy in women undergoing peritoneal dialysis. Our study aims to evaluate the outcomes of pregnancies in women with CKD diagnosed at Hospital São João during the study period. Study design: retrospective case series. Population: pregnant women with chronic kidney disease diagnosed between January 2005 and December 2013. Methods: pregnancies in women with severe CKD (GFR <30mL in/1.73m2) were identified by using hospital electronic platforms with evaluation of maternal and fetal outcomes. Results: during the study period 4 cases of pregnancy in women with CKD were identified, including one of a woman in peritoneal dialysis prior to pregnancy - case 1. Case 1 progressed to hemodialysis at 17 weeks (due to haemoperitoneum subsequent to trauma by the peritoneal dialysis catheter) and had an eutocic late preterm delivery at 35 weeks. Case 2 began hemodialysis at 22 weeks, and was submitted to urgent cesarean section at 29 weeks. Case 3 started hemodialysis at 21 weeks, having also undergone urgent cesarean section at 31 weeks. Case 4 began hemodialysis at 21 weeks, presenting with an episode of hepatotoxicity secondary to darbopoietin at 26 weeks. Delivery occurred by Caesarean section at 32 weeks. Conclusion: despite the high fetal morbidity documented, with the strategies adopted there was no fetal or neonatal mortality. The monitoring of these pregnant in specialized consultation favored the positive outcomes.