gynecology and obstetrics
Renal Insufficiency in Pregnancy
Key Points
Women who have significant renal insufficiency before pregnancy usually cannot maintain a pregnancy to term. In pregnant women with renal insufficiency, measure BP and weight every 2 weeks, and measure BUN and creatinine levels plus creatinine clearance often, as indicated by severity and progression of disease. Consult closely with a nephrologist when treating renal insufficiency in a pregnant woman; delivery is usually required before term. Advances in dialysis treatment have increased life expectancy for patients with end-stage renal disease, improved pregnancy outcomes, and increased fertility, but complication rates for these patients remain high. 