Perinatal and infant outcome of pregnant patients undergoing chronic hemodialysis

Recently, perinatal outcome in patients undergoing chronic hemodialysis has been improved. But the conditions that will most likely result in successf ul pregnancy are still obscure. We retrospectively analyzed 15 pregnant pat ients who were undergoing chronic hemodialysis before pregnancy treated in our perinatal center. We divided these 15 cases into 2 groups: one group of 11 patients whose infants survived and the other group of 4 patients whose infants died 6 h to 8 months after birth due to prematurity. The rate of s uccessful pregnancies having a surviving infant was 73.3% (11/15). We compa red the maternal conditions and the progress of pregnancy in the 2 groups. Significant differences (p < 0.01) were seen as follows. The patients in th e group whose infants survived underwent hemodialysis for a shorter term be fore pregnancy (1-6 years), most of them (9/11) could produce urine (greate r than or equal to 50 ml/day), and the period of gestation was extended (33 .3 +/- 4.7 weeks), so the infants were heavier (1,782.9 +/- 678.3 g). All t he patients who underwent more than 9 years of hemodialysis could not have a surviving infant. From this we can assume that the shorter the period of dialysis before pregnancy, the better the condition is that is likely to re sult in women giving birth and the better is their infant's chance of survi val.