DOI: 10.36347/sjams.2020.v08i05.015

Pages: 1242-1247

Acute renal failure (ARF) of obstetric origin is one of the most life threatening complication of pregnancy which leads to poor foetal and maternal outcome. The incidence of pregnancy related acute kidney injury (PRAKI) in developed countries is 1 in 20000 pregnancies while in India, it is 1 in 50 pregnancies. Though data of PRAKI is available from previous studies, we have to study the prevalence on regular intervals so that appropriate health care measures could be taken immediately. Hence we aim to study the epidemiological and etiological factors of acute renal failure of obstetric origin in Indian society. Pregnant patients who were not having history of renal disease previously and developed acute renal failure as evident by oliguria ( urine output < 400ml/day) or rising azotaemia in presence of normal urine output were included in this study. Detailed history, clinical examination, investigation, management and follow up were done according to protocol. Out of total 1021 cases of acute renal failure, 96 (9.4%) were of obstetric origin and enrolled in study as per inclusion criteria. The maximum incidence of PRAKI was found in the age group of 24-29 years (53.13%) and it was least in patients above 35 years (3.13%). We found puerperal sepsis as the most common etiological factor leading to PRAKI followed by Preeclampsia, Antepartum haemorrhage and Pregnancy related hemolytic uremic syndrome (HUS). The reason for decline in incidence of PRAKI could be the early and effective treatment of pregnancy related complications, improved healthcare facilities and improved health seeking behaviour of people. Health education, very well percolated prenatal care, safe and approved abortion services along with skilled delivery healthcare personnel were the factors that can be worked upon to reduce the epidemiological burden of PRAKI. Simultaneously, strengthening of referral and communication systems among primary, secondary and tertiary health care centres in India will...