Publication:

Acute renal failure in preeclampsia and eclampsia

Background Incidence of acute renal failure (ARF) in preeclampsia and eclampsia is reported to be alarmingly high. Present study was conducted to evaluate the incidence of acute renal failure (ARF) in our institute, to study ARF associated risk factors and its complications along with pregnancy outcome evaluation.

Methods All 812 patients of preeclampsia and eclampsia admitted in the department of obstetrics and gynecology during the study period at our institute were studied. Out of them, the 44 patients diagnosed with ARF were analyzed in detail in terms of maternal age, gravida, booked/unbooked, gestational age, associated complications, management and outcome of pregnancy.

Results ARF was found to occur in 0.4% (2/501) cases of mild preeclampsia, in 16.76% (28/167) cases of severe preeclampsia and in 9.72% (14/144) cases of eclampsia. Intrauterine death (14, 31.82%) was the commonest complication followed by HELLP syndrome (11, 25.0%), post-partum hemorrhage (8, 18.18%) and maternal death (7, 15.9%). Out of 44 cases, 14 (31.82%) had intrauterine death and 8 (18.18%) had fresh stillbirth. Sixteen (36.36%) had low birth weight babies. Total neonatal mortality in present study was observed in 5 (11.36%) cases, 3 in severe preeclampsia group and 2 in eclampsia group.

Conclusions Acute renal failure is seen frequently in patients of severe preeclampsia and eclampsia with associated complications. Maternal and perinatal mortality and morbidity can be prevented in them with earlier detection and management of complications.