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Abstract
We are reporting the first successful pregnancy in a woman on chronic ambulatory peritoneal dialysis in British Columbia. In this paper, we discuss the implications of pregnancy on the peritoneal dialysis, including consideration of adjustments in volume and the frequency of peritoneal exchanges. Hypertension and anaemia are commonly reported in patients with end-stage renal insufficiency and the follow-up and treatment during pregnancy need to be adapted. Treatment of preterm labour needs to be tailored to the compromised renal function. The implications for the fetus, including intra-uterine growth restriction secondary to placental insufficiency, are discussed. The great majority of infants born to women on dialysis are premature. Delivery by Caesarean section should be undertaken only for obstetrical indications. The risks of peritonitis after surgery and the need to discontinue the peritoneal dialysis temporarily after the Caesarean section are added risks to the mother.
Résumé
Nous publions la première grossesse chez une patiente sous dialyse péritoneale ambulatoire en Colombie-Britannique. L’effet de la grossesse sur la fréquence et le volume utilisé pour la dialyse peritonéale est discuté. L’hypertension et l’anémie sont des problèmes fréquemment rencontrés chez les femmes qui souffrent de maladie rénale sevère et le suivi de même que le traitement doivent être ajustés. Le traitement du travail prematuré doit être modifié en tenant compte de la fonction rénale de la patiente. Les conséquences pour le fetus, comme le retard de croissance intra-uterin secondaire à l’insuffisance placentaire sont discutés. La majorité des enfants nés de mère sous dialyse peritonéale sont prématurés. L’accouchement par césarienne devrait être consideré en présence d’une indication obstétricale. Le risque de peritonite dans la periode post-opératoire et la necessité de cesser temporairement la dialyse peritonéale après une césarienne sont des risques additionels pour la mère.
Key Words
References
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Article info
Publication history
Accepted:
April 20,
1997
Received in revised form:
April 20,
1997
Received:
January 16,
1997
Identification
Copyright
© 1997 Published by Elsevier Inc.
