Comparison of bioelectrical impedance analysis in healthy pregnant women and patient on hemodialysis

Abstract

Pregnant woman undergoing dialysis face challenges such as miscarriage and stillbirth when carrying a baby to term. A complication of prenatal care is the difficulty in properly managing body fluids. We compare fluid volumes between healthy pregnant women and two pregnant women undergoing dialysis using bioelectrical impedance analysis (BIA). Data of 52 healthy pregnant women at various stages of their pregnancy were analyzed for the study. We included these many cases so as to collect sufficient data to compare them with our two cases of women undergoing dialysis who successfully completed their term deliveries. Fluid volumes were measured every week before and after dialysis using BIA. We also measured the levels of human atrial natriuretic peptide after dialysis. During dialysis, the dry weight (DW) of pregnant patients is altered based on the state of the amniotic fluid and fetus. However, evaluating body fluid and DW using radiography is difficult in pregnant women. BIA offers a mostly harmless alternative for such measurements. Using BIA, we were able to easily measure body fluid volume and change the setting of DW for dialysis. Thus, our successful example can serve as a reference for future cases of pregnant women undergoing dialysis. Nevertheless, given that the state of the fetus and amniotic fluid affect the results of dialysis, it is important that we use not only BIA but also a comprehensive evaluation to determine dialysis settings in pregnant women.

The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women

“…During the course of pregnancy, ECW tended to rise modestly. FFM, TBW and ECW all increased throughout late pregnancy [35].…”

“…BIA has been used in various clinical situations and pre-pregnancy and pregnancy conditions, including oedema [60], GDM [48,50,51,61,62], excessive gestational weight gain (EGWG) [2,3,48,51,52,55,57,[62][63][64][65], preeclampsia (PE) [57,60,[66][67][68][69][70][71][72][73][74], gestational hypertension (GH) [73,75] or hyperemesis gravidarum [76]. Hashimoto et al compared the impedance analysis in healthy women and in women undergoing haemodialysis whose management of bodily fluids during pregnancy is known to be complicated [35]. Since radiographic examination for the evaluation of cardiothoracic ratio cannot be performed in pregnant women, the alternative use of BIA facilitates the measurement of body fluid volume and setting the corresponding dry weight during dialysis.…”

“…However, for patients with severe abdominal obesity, percentage of body fat may be overestimated [29]. Its safety has been demonstrated in many studies of patients with renal disease, including haemodialysis and transplant patients [30][31][32][33][34][35]. BIA has also been used in patients suffering from diabetes [36], also with concomitant non-alcoholic fatty liver disease (NAFLD) [37,38].…”

Body composition helps: Differences in energy expenditure between pregnant and nonpregnant females

“…BIA is a widely used method to study body composition (Marra et al, 2019), especially during pregnancy. It has been used to monitor maternal longitudinal changes in body composition, to evaluate the relationships between maternal body composition status and fetus health outcomes, and in several clinical studies (Ghezzi et al, 2001; Hashimoto et al, 2020; Larciprete et al, 2003; Liu et al, 2020; Martin, O'Sullivan, & Brown, 2001b; Morita, Takeuchi, Funakoshi, Mizutori, & Maruo, 1999; Piuri et al, 2017; Valensise et al, 2000; Widen et al, 2019; Zhang et al, 2020). However, some limitations have been pointed out for the use of BIA in pregnant females.…”