Effect of ultrafiltration on placental‐fetal blood flow in pregnancy of woman undergoing chronic hemodialysis

Abstract

UF rate of 6 < 8 mL/h/kg during HD did not bring any acute harmful effect on fetal middle cerebral, placental, and umbilical blood flow and the UF rate of 1.4 6 0.4 L (< 6 mL/h/kg) / HD session that was done in all others HD during pregnancy was safe, without any chronic fetal deleterious effect. Obstetric Doppler ultrasonography is a simple and noninvasive method to fetal follow-up and can aid to determine safe UF rate in pregnant women during gestation.

Pregnancy among women undergoing chronic hemodialysis: Effect of ultrafiltration during gestation.

“…The patient has had a healthy boy by vaginal delivered at 36-37 th week and fetal growth matched his gestational age (weight=2595 g and height=47 cm with Apgar score=9) and they were discharged a few days after delivery. However, we could not rule out that UF during HD may have contributed to prematurity [5].…”

“…We study the effect of Ultrafiltration (UF) rate during HD in placental-fetal blood flow [5] by obstetric doppler ultrasonography done in the HD room at the beginning and the end of HD session, in order to obtain doppler velocimetric parameters (pulsatility index and resistance index) of uterine, umbilical and middle cerebral artery: these velocimetric parameters are used to study fetal response to hypoxia in high risk pregnancy.…”

“…However, it is difficult to obtain, even with intensive HD, once most of weight gain in interdialytic period is of fluid. In our study the patient performed to 122 HD sessions after admission in our renal unit and UF was necessary in all HD session [5]. The acute effect of UF in placental-fetal blood flow was studied when UF volume was ≥ 2000 mL (2.18 ± 0.25 L)/HD session with UF rate 6~8 mL/h/kg and doppler velocimetric parameters (pulsatility index and resistance index) before and…”