ACUTE-RENAL-FAILURE OF OBSTETRICAL ORIGIN DURING 1994 AT ONE-CENTER

Although preventable, acute renal failure (ARF) ofobstetrical origin c ontinues to be common in developing countries. During the year 1994, w e treated a total of 238 cases of ARF: Of these cases, 43 (18%) were o fobstetrical origin. All of the patients were known to be previously h ealthy. Acute venal failure occurred in association with antepartum he morrhage in 15, postpartum hemorrhage in 10, intrauterine death of fet us in 11, preeclampsia or eclampsia in 9, and septic abortions or puer peral sepsis in 7. Thirty-sir patients required dialysis therapy becau se of moderate to severe azotemia. Renal histology was studied in 12 c ases. Acute cortical necrosis was present in 9, extensive tubular necr osis in 2, and 1 patient had membranoproliferative glomerulonephritis. Twenty-two (51%) patients recovered normal renal function, while 11 ( 26%) developed irreversible renal dysfunction and 10 (23%) expired. Mo rtality and morbidity in this region is still quite high in obstetrica l situations. Poor health infrastructure and lack of antenatal health clinics leads to development of major complications at the time of chi ldbirth, which is mostly conducted at home by untrained personnel in q uite a few cities of the country.