A Prospective Observational Study of Renal Disorders in Pregnancy in a Tertiary Care Center

Abstract

Background: Renal disorder in pregnancy is one of the life-threatening complications leading to increased maternal morbidity and mortality. The study emphasizes the need for adequate prenatal care and close monitoring of pregnant women with renal disorders. Aim and objectives: (1) To study the incidence of renal disorders in pregnancy, (2) to study the maternal and fetal outcomes in pregnant women with renal disorders, (3) to study the mortality rate of renal disorders in pregnancy, (4) to study the clinical parameters, maternal effects and complications of renal disorders in pregnancy, (5) to study the management modalities of renal disorders in pregnancy. Materials and methods: 50 pregnant women with renal disorders were evaluated over a period of one and a half years. All data collected, analyzed, and presented. Results: During the study period, the total number of deliveries was 7,590, out of which, 50 patients had renal disorders giving an incidence of 0.65%. Out of a total of 50 patients, 15 died, thus maternal mortality was 30%. Maximum patients were from the postnatal group 62% while 38% of patients belonged to the antenatal group. The maximum patients in the antenatal care (ANC) group belonged to the third trimester, while the maximum patients of in the postnatal care (PNC) group belonged to 1st week of PNC in which maximum maternal mortality was seen. Out of 50 patients, 46 patients were found to have acute kidney injury (AKI) (92%) and 4 patients had chronic kidney disease (CKD). Conclusion: Exacerbations of kidney disorder or an occasional diagnosis of nephropathy during pregnancy are relatively common. Successful management of women with renal disorders during pregnancy needs teamwork between obstetricians, physicians, and nephrologists. Proper knowledge is required without any inadvertent intervention and also by avoiding a progression of renal disorder to achieve good maternal and perinatal outcomes. Early recognition, appropriate management, and prompt referral to specialized centers can improve outcomes.