Delivery of healthy infant during hemodialysis session

Acute renal failure secondary to bilateral ureteral obstruction in pregnanc y is rare, We describe a case of acute renal failure secondary to bilateral ureteral obstruction. A 27 year-old woman at 35 weeks' gestation was refer red to our hospital with a diagnosis of acute renal failure. The patient ha d been well until four days earlier, when she developed an abrupt anuria. S he had been administrated excessive amounts of fluids, and unresponsive to parenteral furosemide, She had mild pitting oedema and an S-3 gallop with c rackles in the lungs, The uterus was enlarged to the expected size with a c ervical dilatation of 2 cm in diameter. Her serum creatinine level was 7.0 mg/dl. Renal ultrasound showed bilateral hydronephrosis of severe degree. T he patient was immediately hemodialyzed for advanced renal failure with hyp ervolemia, and a healthy infant was born at the third hour of the HD sessio n without any complication. On the next day, her urine volume was 200 ml/da y and serum creatinine level was 6.8 mg/dl. For this reason, the patient un derwent cystoscopy and ureteral stents were inserted bilaterally. There was no evidence of ureteral stones or obstructive lesions. After the stenting, the urine volume increased and serum creatinine was decreased gradually to normal level at the seventh day of postpartum. Two weeks: later ureteral s tents were removed and both infant and patient were completely healthy, To the best of our knowledge, this is the first case of delivery of an infant during a haemodialysis session.