Pregnancy on Intensified Hemodialysis: Fetal Surveillance and Perinatal Outcome
Pregnancy on Intensified Hemodialysis: Fetal Surveillance and Perinatal Outcome
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强化血液透析妊娠：胎儿监测和围产期结果
DOI：
10.1159/000100793
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发表时间：
2007
影响因子：
2.2
通讯作者：
J. Hartung
中科院分区：
文献类型：
--
作者：
C. Bamberg;F. Diekmann;M. Haase;K. Budde;B. Hocher;H. Halle;J. Hartung
目的：探讨多普勒超声强化胎儿监护和胎儿无应激试验对强化血液滤过孕妇围产期结局的影响。方法：根据产妇背景、妊娠期血液透析计划、血压、胎儿并发症发生情况、产科并发症发生情况、分娩周数、分娩方式、新生儿结局及随访等参数，对5例连续妊娠强化血液透析妇女进行分析。结果：所有妊娠均为活产，平均胎龄32周。宫内生长受限4例，病理脐动脉血流速度波形2例。平均出生体重为1764克（1274 - 2465克）。3例因胎儿窘迫行剖宫产术。没有患者出现像先兆子痫这样的严重并发症。结论：虽然强化透析能够维持子宫胎盘和胎儿的稳定灌注，但强化胎儿监测对于降低维持透析孕妇的围产期发病率和死亡率是必要的。
Objectives: To evaluate the effect of intensive fetal surveillance via Doppler ultrasound and fetal non-stress test on the perinatal outcome of pregnant women undergoing an intensified hemofiltration scheme. Methods: Five consecutive pregnancies of women undergoing intensified hemodialysis were analyzed due to the following parameters: maternal background, hemodialysis schedule during pregnancy, blood pressure, occurrence of fetal complications, occurrence of obstetric complications, gestational week at delivery, mode of delivery, and newborn outcome and follow-up. Results: All pregnancies resulted in a live birth, mean gestational age was 32 weeks. Intrauterine growth restriction occurred in 4 fetuses, pathological umbilical artery flow velocity waveforms in 2. The mean birth weight was 1,764 g (range 1,274–2,465 g). Cesarean section was performed in 3 patients because of fetal distress. None of the patients developed severe complications like pre-eclampsia. Conclusions: Although intensified dialysis enables the maintenance of stable uteroplacental and fetal perfusion, intensive fetal monitoring is mandatory to reduce perinatal morbidity and mortality in pregnant women on maintenance dialysis.