Peritoneal dialysis in pregnancy: A case series

Jefferys, Andrew; Wyburn, Kate; Chow, Josephine; Cleland, Bruce; Hennessy, Annemarie

doi:10.1111/j.1440-1797.2008.00938.x

Cited by 30 publications

(22 citation statements)

References 16 publications

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“…Most women in this study received hemodialysis. Although pregnancy rates are lower in women treated with peritoneal dialysis (5), successful pregnancies in peritoneal dialysis patients in Australia have been previously reported (24). In our study, dialysis modality was not associated with outcome, although analysis was limited as the peritoneal dialysis cohort was small and pregnant women generally started on hemodialysis.…”

Section: Discussionmentioning

confidence: 38%

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Jesudason

Grace

McDonald

2014

Clinical Journal of the American Society of Nephrology

142

125

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SummaryBackground and objectives Pregnancy in ESRD is rare and poses substantial risk for mother and baby. This study describes a large series of pregnancies in women undergoing long-term dialysis treatment and reviews maternal and fetal outcomes. Specifically, women who had conceived before and after starting long-term dialysis are compared.Design, setting, participants, & measurement All pregnancies reported to the Australian and New Zealand Dialysis and Transplantation Registry from 2001 to 2011 (n=77), following the introduction of specific parenthood data collection, were analyzed.Results Between 2001 and 2011, there were 77 pregnancies among 73 women. Of these, 53 pregnancies were in women who conceived after long-term dialysis was established and 24 pregnancies occurred before dialysis began. The overall live birth rate (after exclusion of elective terminations) was 73%. In pregnancies reaching 20 weeks gestation, the live birth rate was 82%. Women who conceived before dialysis commenced had significantly higher live birth rates (91% versus 63%; P=0.03), but infants had similar birthweight and gestational age. This difference in live birth rate was primarily due to higher rates of early pregnancy loss before 20 weeks in women who conceived after dialysis was established. In pregnancies that reached 20 weeks or more, the live birth rate was higher in women with conception before dialysis commenced (91% versus 76%; P=0.28). Overall, the median gestational age was 33.8 weeks (interquartile range, 30.6-37.6 weeks) and median birthweight was 1750 g (interquartile range, 1130-2417 g). More than 40% of pregnancies reached .34 weeks' gestation; prematurity at ,28 weeks was 11.4% and 28-day neonatal survival rate was 98%.Conclusions Women with kidney disease who start long-term dialysis after conception have superior live birth rates compared with those already established on dialysis at the time of conception, although these pregnancies remain high risk.

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Section: Discussionmentioning

confidence: 38%

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Jesudason

Grace

McDonald

2014

Clinical Journal of the American Society of Nephrology

142

125

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“…Case series are infrequent and many do not include women who were on PD prior to conception [27]. There are several complications that are unique to PD including exit site infections, catheter malposition and drainage difficulties, polyhydramnios, and peritonitis [28-30].…”

Section: Pregnancy Outcomesmentioning

confidence: 99%

Pregnancy and End-Stage Renal Disease

2018

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Pregnancy is uncommon in women with end-stage renal disease (ESRD). Fertility rates are low in women on dialysis, and physicians still frequently counsel women with ESRD against pregnancy. Advancements in the delivery of dialysis and obstetric care have led to improved live birth rates in women on dialysis, so pregnancy for young women with ESRD is now more feasible and safer. However, these pregnancies remain high-risk for both maternal and fetal complications, necessitating experienced multidisciplinary care. In this article, we review fertility issues in women with ESRD, discuss pregnancy outcomes in women on dialysis, and provide an approach for management of pregnant women with ESRD.

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“…Holley et al suggest starting dialysis at a 28.6 mmol/L urea and aiming to keep it below 18 mmol/L, while Jefferys and colleagues recommend keeping the urea less than 10 mmol/L and the creatinine as low as possible [6, 20]. With both our patients, we aimed to keep the urea less than 15 mmol/L.…”

Section: Management Of Pregnancymentioning

confidence: 96%

Dialysis and Pregnancy in End Stage Kidney Disease Associated with Lupus Nephritis

Sivasuthan

Dahwa

John

et al. 2013

Case Reports in Medicine

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Female patients with systemic lupus erythematosus are often of childbearing age at diagnosis, and though fertility in these patients is similar to the general population, successful pregnancy remains a rare occurrence. This incidence is, however, increasing and the management of these high risk pregnancies is often further complicated by the patient's need for dialysis as a result of lupus nephritis (LN). We share our experience in managing two LN patients with successful pregnancies, one on automated peritoneal dialysis and the other on haemodialysis, as well as a review of cases in the literature.

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Peritoneal dialysis in pregnancy: A case series

Cited by 30 publications

References 16 publications

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Pregnancy Outcomes According to Dialysis Commencing Before or After Conception in Women with ESRD

Pregnancy and End-Stage Renal Disease

Dialysis and Pregnancy in End Stage Kidney Disease Associated with Lupus Nephritis

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