Graviditet och barnafödande nu möjligt för kroniskt njursjuka kvinnor. Dialysbehandling bör intensifieras under graviditet, visar fem fall
Sammanfattning
The advice to women with endstage renal disease who want to have children has earlier been to await kidney transplantation. However, today pregnancy and childbirth are possible even for women with severe renal failure and hemodialysis.The treatment strategies with intensive, frequent dialysis treatment, avoidance of fetal toxic drugs, intensive anemia treatment with ESA (erythropoiesis stimulating agents) are some reasons for the improved results. There is an increased risk for these women of developing preeclampsia. Most women in our series also received blood transfusions because of anemia. Two mothers are now heavily immunized which may complicate future kidney transplantation. Close cooperation between the nephrologist and the obstretician at all stages of pregnancy is necessary for optimal care.