NEPHROLOGICAL EVALUATION OF PREGNANT WOMEN REFERRED BY GYNECOLOGY: A CASE SERIES FROM A TERTIARY CARE HOSPITAL

 

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  NEPHROLOGICAL EVALUATION OF PREGNANT WOMEN REFERRED BY GYNECOLOGY: A CASE SERIES FROM A TERTIARY CARE HOSPITAL

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ELBA
MEDINA
ELBA MEDINA ONELIDA@MSN.COM HOSPITAL GENERAL DE MEXICO DR. EDUARDO LICEAGA NEPHROLOGY CDMX Mexico *
MARIELA ALARCON marielalarcong97@gmail.com HOSPITAL GENERAL DE MEXICO DR. EDUARDO LICEAGA INTERNAL MEDICINE CDMX Mexico -
 
 
 
 
 
 
 
 
 
 
 
 
 

 Nephrological evaluation of pregnant women referred by gynecology: a case series from a tertiary care hospital. Pregnancy in patients with impaired renal function represents a clinical challenge due to the increased risk of maternal and fetal complications. Timely consultation with a nephrologist allows for a comprehensive and multidisciplinary approach. The aim: to describe the clinical and diagnostic characteristics and management of pregnant women with kidney damage referred by the gynecology department for evaluation by inpatient nephrology or to the outpatient department at a tertiary care hospital.


Case series. Pregnant women evaluated by the nephrology department from November 2024 to the present were included. Reasons for referral, clinical variables, renal function parameters, and maternal and fetal outcomes were analyzed.

Thirty-three patients were included, age 29.82 ± 6.9, 26 of the 33 patients were pregnant at the time of the initial evaluation, 25.7 ± 9.5 weeks of gestation (GGT), 5 were postpartum, and two had miscarriages, one at 11 GGT and the other unspecified. The reasons for consultation were preeclampsia (n = 8), miscarriages and kidney injury (n = 2), chronic hypertension (n = 1), chronic kidney disease (n = 6), glomerulopathy (n = 6), diabetes (n = 4), hydronephrosis (n = 3), acute kidney injury (n = 2), and intoxication (n = 1). At the time of the initial evaluation, the mean urea level was 71 ± 57.52 mg/dL and creatinine 2.67 ± 2.61 mg/dL. Eighteen of the 33 patients had no known kidney damage prior to pregnancy. Four patients required renal replacement therapy with hemodialysis. Fetal outcomes encompassed miscarriages (n=3), spontaneous abortions (n=2), induced abortions (n=1), low birth weight (n=11), ICU admissions (n=4), and postnatal mortality (n=1).

Kidney disease in pregnancy, whether previously diagnosed or not, is associated with a high risk of maternal-fetal complications. This case series showed a high proportion of patients with a de novo renal diagnosis during pregnancy and significant adverse fetal outcomes. Early evaluation with nephrology and multidisciplinary follow-up are essential to optimize the prognosis.

Kewords