POST-OPERATIVE ACUTE KIDNEY INJURY IN WOMEN WHO UNDERWENT EMERGENCY OBSTETRIC SURGERY AT MUHIMBILI NATIONAL HOSPITAL IN DAR ES SALAAM, TANZANIA

E-Poster

https://storage.unitedwebnetwork.com/files/1099/178190123a91b415afaea339a8e556d7.pdf

Abstract Title

First Name *

Indhadek

Last Name *

Mohamed Ali Odey

Co-author 1

Dr. Fadhlun Mohamed Alwy Al-beity fadhlundr@gmail.com Muhimbili University of Health and Allied Sciences (MUHAS) Obstetric and gynecology dar es salam

Co-author 2

Dr. Peter Wangwe drwangwe@yahoo.com Muhimbili University of Health and Allied Sciences (MUHAS) Obstetric and gynecology dar es salam

Co-author 3

Dr. Jacqueline Shoo shoojacqueline@gmail.com Muhimbili National Hospital (MNH) Nephrology dar es salam

Co-author 4

Belinda Balandya lindabsoft@gmail.com Muhimbili University of Health and Allied Sciences (MUHAS) Obstetric and gynecology dar es salam

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Acute kidney injury (AKI) is one of the most overlooked post-operative complications and yet associated with increased morbidity and mortality. AKI occurring after emergency obstetric surgery is an area that requires attention and further characterization. This study was carried out to determine the proportion, clinical profile ,outcomes and treatment modalities of postoperative AKI in emergency obstetric surgery at a Tertiary Hospital in Tanzania.

Methods

The study was a retrospective cohort study, included all patients who underwent emergency obstetric surgery, delivered at gestational age ≥ 28 week at the Department of Obstetrics and Gynecology at Muhimbili National Hospital, Tanzania, from 2019 to 2021 .Data were collected from theatre records, hospital electronic system and inpatient files, using a structured checklist; information included clinical profile and laboratory parameters. We excluded patients with history chronic kidney disease and patients without baseline serum creatinine or follow-up serum creatinine levels. Acute kidney injury (AKI) was identified by Kidney Disease Improving Global Outcome KDIGO-criteria for serum creatinine ,during seven days of an operative intervention. Data was processed using IBM Statistical Package for the Social Sciences (SPPS) v23.0 software.

Results

In the cohort, a total of 952 women underwent emergency obstetric surgery,180 patients were included in our analysis.54 out of 180 obstetric surgical patients (30%) developed AKI, within postoperative day seven (POD7), of these 26(48.1%) had AKI Stage I, 8(14.8%) had AKI Stage II and 20 (37%) had AKI Stage III, forty-two (78%) of these developed AKI within the first 48 hours of surgery. The mean age of AKI patients were 29.50 (± 7.20) years. The Outcome of participants who had AKI include 19 (35.2%) had full renal recovery, Persistent AKI 35 (64.8%) and death occurred in 11 (20.4 %),Thirty-six (66.7%) were managed conservatively, hemodialysis was done in 18(33.3%) of patients.

Conclusions

The proportion of Acute Kidney Injury is high after emergency obstetric surgery. The majority of AKI patients were managed conservatively, though some required dialysis and the mortality due to AKI is alarming. Further studies required to investigate the risk factors for AKI and the associated outcomes in the obstetric population.

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