Maternal and Fetal Outcomes in Pregnant Women with Chronic Kidney Disease Based on Glomerular Filtration Rate

Abstract

Introduction: Pregnancy causes adaptations in the kidney, both in anatomy and function, to maintain the extracellular, hemodynamic and hormonal environment. However, these may not be carried out completely optimally in the presence of kidney disease. The objective was to study the relation between kidney disease and maternal-fetal outcomes during pregnancy, associated with a rejection by patient and/or relative to specialized treatment.

Material and Methods: Observational, retrospective study in a series of cases, reviewing 134 files of pregnant patients with some degree of kidney disease prior to
pregnancy. Maternal outcomes recorded were: hypertensive disease during pregnancy, acute renal deterioration, need for renal substitution therapy, and in products:
prematurity, restriction of intrauterine growth, fetal death. and miscarriage.

Results: Maternal outcomes: mean glomerular filtration rate (GFR) of 58.23 ml/min, weight gain of 7 kg; preeclampsia was diagnosed in 92 women (55 severe).
46 patients showed acute renal lesion, 40 were conservatively resolved; 1 required peritoneal dialysis and 15 hemodialysis (with decision delayed an average of one
month by rejection by patient and/or relative). Resolution of pregnancy was by cesarean in 111 patients; 116 products were born before 37 weeks of gestation, with
average weight of 1910 g, 94 showed restriction of intrauterine growth.

Conclusion: Kidney disease directly influenced the greater number of adverse maternal and fetal outcomes when specialized medical care was rejected. There is a
correlation between slight Davison state with states I, II and IIIa of KDIGO in correspondence analysis.