Abstract
Pregnancy outcomes in patients on chronic dialysis have improved as a result of the intensification of dialysis and improved perinatal care. We report the successful outcome of a pregnancy in a patient on chronic haemodialysis in Cape Town, South Africa. With intensification of her therapy using thrice-weekly, nocturnal haemodialysis the pregnancy was maintained until 34 weeks at which time a 1.86 kg baby boy was delivered by elective caesarean section. One year later the patient was doing well on maintenance haemodialysis and the baby was achieving his developmental milestones. This report highlights our ability to employ a multi-disciplinary approach and prolonged, nocturnal haemodialysis to support pregnant dialysis patients in the South African setting and achieve good outcomes for both mother and baby.
Highlights
The first successful pregnancy in a patient on chronic haemodialysis was reported by Confortini et al in 1971 [1]
It is estimated that pre-eclampsia affects more than 75% of pregnant haemodialysis patients
In South Africa, it is uncommon for patients on chronic dialysis to have successful pregnancies, colleagues from around the country have indicated that they have had occasional patients with good outcomes
Summary
The first successful pregnancy in a patient on chronic haemodialysis was reported by Confortini et al in 1971 [1]. The recent meta-analysis by Piccoli et al [4] highlights the improving pregnancy outcomes in both haemo- and peritoneal dialysis patients. This encouraging trend has been achievable primarily through the intensification and increased duration of haemodialysis sessions and by improved perinatal care. In South Africa, it is uncommon for patients on chronic dialysis to have successful pregnancies, colleagues from around the country have indicated that they have had occasional patients with good outcomes. We report the successful outcome of a pregnancy in a patient on chronic haemodialysis in Cape Town, South Africa.
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