The article was consulted professionally by Specialist I Nguyen Hung – Department of Medical Examination and Internal Medicine – Share99 Da Nang InternationalHealth Hub.
Pregnant women with chronic kidney disease have a poor adaptation to an increase in blood flow in the kidneys. This can increase the deterioration of renal function and lead to poor pregnancy as a result.
1. What is chronic renal failure?
Chronic renal failure is the process of impaired functioning of the kidneys. At this time, the kidneys can not remove waste products as well as lose the function of controlling the body's water volume, blood salt, waste products in the body and affecting the health of the patient.
Chronic renal failure needs to be treated promptly otherwise it will cause serious complications.
2. Stages of chronic renal failure during pregnancy
Chronic kidney disease is usually not manifested in the early stages. The disease is usually detected when it has worsened.
Chronic renal failure occurs when the level of dialysis of the renal dialysis decreases below 25% below normal levels, and more than 50% of renal function may be lost before serous creatinine increases to 120 μmol/l.
Pregnant women with a creatinine value above 124μmol/l are at risk of rapid renal function reduction and result in poor pregnancy. It is necessary to consider the condition of pregnant women with chronic kidney disease to minimize the adverse effects of pregnancy on the renal function of the mother and affect the fetus.
Chronic kidney disease is classified in 5 stages. Stages 1 and 2 (normal or mild renal failure) affect 3% of women of child age (20-29 years old). Stage 3 – 5 (dialysis rate less than 60ml) affects 1 in 150 women of child age but due to the decrease in fertility and a fairly high rate of miscarriage, the pregnancy in these subjects is very small.
Some subjects were found to have chronic kidney disease during pregnancy. About 20% of women suffer from pre-maternity seizures at a pregnancy of less than 30 weeks, especially those with severe proteinuria, previously, not recognized as chronic kidney disease.
3. How does pregnancy affect kidney function?
Most pregnant women often have mild renal dysfunction, and pregnancy usually does not affect kidney function. The condition of the pregnant woman will vary from average renal failure to severe renal failure.
According to some studies, women with severe renal failure before pregnancy are at risk of rapid impairment of renal function during pregnancy. Proteinuria and hypertension both increase this risk.
Chronic hypertension puts pregnant women at risk of pre-seizures, which may explain why some women with mild renal dysfunction also suffer from impaired renal function during pregnancy. The risk of a decrease in renal function decreases if hypertension is controlled.
Hypertension, proteinuria and urinary tract infections often coexist in pregnant people with chronic kidney disease and it is difficult to determine how these factors each affect pregnancy results.
Women with chronic renal failure are very difficult to conceive, the rate of miscarriage is high, and the results of pregnancy are also poor.
4. Chronic renal failure and the possibility of pregnancy/childbirth
In Vietnam, in the past 40 years, there has only been one pregnancy and the first childbirth when the mother with chronic kidney disease is in the process of dialysis. As such, it can be seen that women with chronic renal failure can give birth, however this is very difficult because chronic kidney failure is a dangerous disease, dangerous for the mother herself and also the fetus.
All women with chronic kidney disease should be examined early during pregnancy. For some subjects, the treatment of chronic kidney disease during pregnancy is associated with the treatment of clinical characteristics of the disease, it is necessary to regularly monitor the renal function of the mother, blood pressure, infections and proteinuria.
At best, all women with chronic kidney disease need to be aware of the risks to the functioning of the mother's kidneys and the effect on the fetus during their pregnancy. Women with chronic kidney disease often suffer from asym neurone disease but can sometimes still ovulate and it can conceive. Contraceptives should be considered for clinical pathology. The treatment of patients with chronic renal failure depends on the patient's condition and health status.
Specialties in Endnistdicents – Diabetes, Share99 International Health Hub is one of the addresses for examination and treatment of endo noisynoid diseases such as: Sedentary – thyroid – Diabetes mellitus and a manh kidney glands, including chronic renal failure.
The specialties work closely with the IVF Center – Obstetrics and Gynecology Department in managing patients with end of end end of life during pregnancy, thereby having appropriate prevention and treatment plans, protecting the health of mothers and babies.
Dr. Nguyen Hung graduated as a specialist in General Internal Medicine – Ho Chi Minh City University of Medicine and Pharmacy; speak English and French. With more than 36 years of experience in the profession, of which 17 years is the Head of Renal and Endirinal Department of Da Nang Health Hub, the doctor has experience in the treatment of endo noisular – diabetes and kidney diseases. Currently, he is a doctor treating end endo noisies at the Department of Medical Examination and Internal Medicine at Share99 Da Nang International Health Hub.
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