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Can Women Get Pregnant with Chronic Kidney Disease (CKD)

2012-09-21 10:15

Can Women Get Pregnant with Chronic Kidney Disease (CKD)It is reported that most of women with Chronic Kidney Disease(CKD) can have a successful pregnancy. However, pregnancy is actually a challenge in all CKD stages.

High blood pressure and heavy proteinuria are closely associated with a poor outcome of pregnancy. High blood pressure can be dangerous for both mother and the fetus. It can increase the risk of developing complications like preeclampsia, premature delivery and stillbirth. The risk  is reduced when high blood pressure is controlled. In addition, women with both an estimated glomerular filtration rate<40ml/min and proteinuria>1g/24h before pregnancy show an accelerated decline in renal function during pregnancy. The degree of renal impairment is associated with the risk of a poor pregnancy outcome.

Women with severe renal impairment have the greatest difficulty conceiving, the highest rate of miscarriage, and the poorest pregnancy outcome.

In conclusion,women with mild renal dysfunction( stages 1~2) are usually related to an uneventful pregnancy and good kidney outcome. However, for the women with stage 3~5, as their kidneys are damaged severely, they are at highest risk of complications during pregnancy and also the risk of accelerated decline in renal function is pretty high. Also, heavy proteinuria, uncontrolled blood pressure and urinary tract infection can affect the pregnancy and the safety of mother and fetus in an adverse way.

To get a successful pregnancy, the overall medical conditions of women with CKD should be evaluated before pregnancy. All women should be made aware of the risks to their long term renal function and to the fetus to the fetus before they conceive. What’s more,they should be monitored during pregnancy and adjust their medications with surveillance of their doctor to guarantee the safety of both mother and fetus. During pregnancy, if the mother’s renal function deteriorates rapidly due to pregnancy, termination of pregnancy may be ordered.

The most important aspects of managing CKD in pregnancy relates to managing associated clinical features. Regular monitoring of maternal renal function, blood pressure and infection, proteinuria is necessary during pregnancy. If CKD can be controlled well during pregnancy, the chance of a successful pregnancy will increase remarkably.

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