Abstract
Women of childbearing age on conventional hemodialysis (HD) had decreased fertility when compared with the general population, although it is not impossible. Furthermore, in women who conceived, maternal and fetal morbidity and mortality remained elevated. Only few publications addressed the status of pregnancy in HD females in Egypt. Thus, the aim of the current study was to assess the frequency and consequences of conception rate in Egyptian HD females. The study comprised 2 phases: Phase one investigated the frequency of conception in hemodialysis females in 291 HD units all over Egypt, while phase two studied the consequences of conception and factors affecting its fate in 22 HD units comprising 211 married females in their childbearing period. The 5-year conception rate was 5.2%, and was associated with higher dialysis blood flow rate, larger dialyzer size, longer session length, better control of blood pressure, as well as lower level of serum ferritin. Live birth frequency was 33.3% of conception; and compared to cases with abortion, it was statistically significantly associated with younger maternal age, and insignificantly associated with higher length of dialysis sessions and lower serum phosphorus level. During the third trimester, a dialysis duration of 24 hours/week resulted in better conception outcomes compared to respective dialysis duration of 20 hour/week, although the differences were statistically insignificant. The viable babies’ weights ranged between 0.9 – 3.5 kg with a mean of 2.1 kg. Compared to vaginal delivery, Caesarian sections were attended by better neonatal outcomes. The mean gestational age was 32.6 weeks with range of 24 to 36 and there was no pregnancy-related maternal mortality. Fertility is not uncommon and is largely safe in married Egyptian HD female. Better conception potentials and outcomes could be related to better dialysis adequacy, and proper control of phosphate.
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