Gravidez e Hemodiálise: A Propósito de uma Gravidez Gemelar Bem Sucedida

Medeiros, Rita; Pais, Maria; Freitas, Luís Carlos Bastos; Moura, Paulo

doi:10.20344/amp.11377

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…The twins were delivered by caesarian section at 25 weeks of gestation and weighed 790 and 870 g, respectively. In 2021, a Portuguese group described a bichorial‐biamniotic pregnancy discovered at 19 weeks in a woman undergoing hemodialysis who already had three pregancies 3 . After the diagnosis of pregnancy, the patient underwent dialysis for 4 × 5 h/week and then from 27 weeks for 6 sessions/week (duration unknown), and two healthy living boys weighing 2220 and 2260 g, respectively, were delivered by caesarean section at 40 weeks.…”

Section: Discussionmentioning

confidence: 99%

Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis

Desbuissons,

Ngango,

Baudeau

et al. 2024

Hemodialysis International

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Although pregnancy has become more frequent in patients undergoing hemodialysis, it remains a relatively rare event and carries a high risk of complications for both the mother and the fetus. In parallel, multiple pregnancies are also associated with a high risk of complications for the mother and the fetus, even in healthy women. The presence of a twin pregnancy in a woman with chronic renal failure undergoing hemodialysis is an even rarer event and is considered a very high‐risk situation. We describe the case of a 31‐year‐old hemodialysis patient who successfully gave birth to twins at 29 weeks after a period of alternate diurnal and nocturnal hemodialysis.

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Section: Discussionmentioning

confidence: 99%

Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis

Desbuissons,

Ngango,

Baudeau

et al. 2024

Hemodialysis International

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“…In Cameroon, the average age of diagnosis of pregnancy is 15.8 ± 4.02 weeks and no case of multiple pregnancy has been reported previously in the hemodialysis population [ 9 ]. Similarly, only a few cases of spontaneous twin pregnancy have been reported worldwide [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Twin Pregnancy: A Challenging and Exceptional Scenario in a Patient on Maintenance Hemodialysis in Sub-Saharan Africa

Mahamat

Fouda

et al. 2022

Case Rep Nephrol Dial

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Chronic hemodialysis is associated with reduced fertility. Hence, pregnancy remains rare, challenging, and deleterious when unplanned, especially in low-resource countries. Contraception and births are very important in these settings. Though the main modes of contraception have been proposed in the chronic kidney disease (CKD) population, contraception still remains challenging in patients on maintenance hemodialysis. Most doctors, however, overlook contraception because of the low fertility, high rate of amenorrhea, and low libido. Furthermore, patients are less receptive to contraceptive counseling either because of a high desire to give birth or due to amenorrhea and low libido. Management of unplanned pregnancies is therefore very challenging and a multidisciplinary approach is the rule; however, it does not guarantee a good prognosis for both the mother and child. Very few cases of multiple pregnancies without induction of ovulation have been reported in patients with severe renal failure, especially those on maintenance dialysis. A 32-year-old multiparous woman with end-stage kidney failure (ESKF) and a residual diuresis of 700 mL per day who had been on inadequate maintenance hemodialysis for 36 months, presented with abdominal distension, which was confirmed on abdominal ultrasound to be a twin pregnancy at 22 weeks of gestation. Thereafter, we intensified hemodialysis (3 sessions/week), managed hypertension and anemia. The obstetrical course was uneventful until the 25th week of gestation when she developed grade 3 (WHO) hypertension and peripheral fluid overload. At the 29th week, she had a spontaneous vaginal preterm delivery of 2 babies weighing 1,350 g and 1,000 g, with an Apgar score of 8 and 7, respectively. Babies, however, died on day 1 and day 5 postpartum, respectively, from respiratory distress and early neonatal infection. The evolution of the mother was uneventful as she continued with her hemodialysis sessions. Twin pregnancies are a rare and very high-risk condition in end-stage renal disease and require multidisciplinary management.

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Gravidez e Hemodiálise: A Propósito de uma Gravidez Gemelar Bem Sucedida

Cited by 2 publications

References 13 publications

Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis

Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis

Spontaneous Twin Pregnancy: A Challenging and Exceptional Scenario in a Patient on Maintenance Hemodialysis in Sub-Saharan Africa

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