ACUTE-RENAL-FAILURE IN PREGNANCY

From 1976 to 1994, 57 women were referred to the Centro de Nefrologia, Montevideo, with obstetric acute renal failure (ARF). The main causes were hypertensive disorders such as preeclampsia (PE) in 27, acute py elonephritis of pregnancy (APN) in 26, and idiopathic postpartum renal failure in 3. Severe preeclampsia superimposed on chronic hypertensio n and acute pyelonephritis of pregnancy complicated by sepsis accounte d for more than 50% of the cases of ARF. Chronic renal failure develop ed in 6 patients: 2 had bilateral renal cortical necrosis, 1 had malig nant nephrosclerosis, and 3 had idiopathic postpartum renal failure. M aternal mortality related to ARF was low in this group of patients (le ss than 2%). In contrast, perinatal mortality was strikingly high (40% ).