Publication:

A retrospective analysis of outcome of pregnancy with acute renal failure during a period of one year at Geetanjali medical college & hospitals, Udaipur, Rajasthan, India

Background Acute kidney injury (AKI) is a life threatening complication of pregnancy. Pregnancy related Acute Renal Failure is usually a consequence of obstetric complication like pregnancy induced hypertension, pre eclampsia, eclampsia, septic abortion, HELLP, antepartum hemorrhage, and puerperal sepsis.

Methods ARF was diagnosed when there was a history of sudden oliguria (urinary output 0.5mg/dl/day from baseline. All patients with obstetrical ARF, antepartum as well as postpartum, were included in this study.

Results From 256 patients, 15 patients (5.8%) had pregnancy related ARF. Maternal outcome was assessed according to grading of AKI. The causes of ARF were pre eclampsia and eclampsia (40%), HELLP (13.33%), APH (13.33%), PPH (20%) and puerperal sepsis (6.66%). Maternal mortality was 13.33%. Neonatal outcome, amongst 14 patients, was noted and analyzed. Intrauterine deaths amongst them were 4/14 (28.57%). Amongst 10 neonates which were admitted in neonatal ICU, 6/10 (60%) survived and 4/10 (40%) of them died.

Conclusions Multidisciplinary services at tertiary level may reduce mortality due to Pregnancy related Acute Renal Failure. Most common etiological factor was pre eclampsia and eclampsia. Disappearance of illegal abortion, improvement in ANC with effective management of complicated pregnancy, the facility for safe early elective delivery whenever indicated, the improvement in resuscitation of obstetric hemorrhage and increased preparation of hospital birth had all contributed to the prevention of this devastating complication of pregnancy.