Study of Acute Kidney Injury Secondary to Obstetric Complications in the Third Trimester of Pregnancy and the Puerperium

Abstract

Background: Acute kidney injury (AKI) includes a group of clinical syndromes that primarily manifest as a rapid decline in thekidney function in association with the accumulation of metabolic waste. Aim:The aim of our study is to assess the prevalence and outcome of acute kidney injury secondary to obstetric complications in the third trimester of pregnancy and the puerperium.Subjects:study is a retrospective study that was conducted on 80 patients presented with acute kidney injury secondary to obstetric complications in third trimester of pregnancy and puerperium.All pregnant females aged more than 18 years old who experienced an episode of AKI during the third trimester of pregnancy and puerperium. The commonest cause of AKI in the third trimester of pregnancy and puerperium was obstetric haemorrage (50%) followed by hypertensive disorders of pregnancy (35%) including preeclampsia, eclampsia and HELLP then TMA (7.5%) and septic AKI (7.5%).The diagnosis of AKI in pregnancy and the subsequent management usually depend on the clinical evaluation and routine investigations but in some cases the diagnosis is very challenging that calls for renal biopsy (6.3%).AKI in pregnancy is associated with high fetal mortality of (73.8%). Conclusion:In developing countries, AKI in pregnancy remains a frequent and grave complication. It reflects the absence of prenatal care and early detection of high-risk pregnancies, the delay in transfer of patients and the paucity of relevant human and material resources. It is certainly preventable and treatable ncomplication, but one that imposes a heavy burden of maternal morbidity and mortality if its diagnosis and treatment are delayed. Recommendations:Larger number of patients & multi-centre studies will provide more information about incidence and prevalence of acute kidney injury in pregnancy. Give special attention to pregnant women with preeclampsia or any other risk factors during the pregnancy and during the postpartum period and care with doing routine investigations and document the results for further future studies. Keywords: AKI, HELLP, TMA, pregnancy.