2011, Número 05
Ginecol Obstet Mex 2011; 79 (05)
Vázquez-Rodríguez JG, Rivera-Hernández M
Referencias bibliográficas: 22
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RESUMENBackground: Pregnant patients with chronic renal insufficiency (CRI) have a high risk of perinatal complications and deterioration of renal filtration (RF).
Objective: To report perinatal complications and changes of RF according to disease severity.
Material and method: Cross-sectional study including 28 pregnant patients grouped into three categories of CRI according to initial creatinine (Cr): mild CRI ‹ 1.5, moderate CRI 1.5-2.5 and severe CRI ›2.5 mg/dL. Pre-labor vs initial perinatal complications and changes in endogenous creatinine clearance (CrCl) were reported. Descriptive statistics and Student t-test were used for statistical analyses.
Results: Mild CRI was found in 50%, moderate in 35.72% and severe in 14.28% of patients. Maternal complications were as follows. Mild CRI: Cesarean (35.72%), deterioration of RF (21.42%) and worsening of systemic arterial hypertension (SAH) (7.14%); moderate CRI: Cesarean (28.57%), deterioration of RF (28.57%) and worsening of SAH (14.28%); severe CRI: Cesarean (14.28%), deterioration of RF (14.28%) and anemia (14.28%). Fetal complications were as follows. Mild CRI: prematurity (25%), fetal growth restriction (FGR) (7.14%) and fetal death (7.14%), moderate CRI: prematurity (21.42%), FGR (3.57%) and no reassuring fetal status (NRFS) (3.57%), severe CRI: prematurity (14.28%), NRFS (7.14%) and respiratory insufficiency (7.14%). Mild CRI showed a reduction of endogenous CrCl (p = 0.03) not shown in other categories.
Conclusion: An elevated frequency of complications was found, with the most serious occurring in patients with severe CRI. Deterioration of RF was found in patients with mild CRI.
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