DOI: https://doi.org/10.36347/sasjm.2025.v11i03.007

Pages: 161-163

Introduction: The decline in kidney function disrupts reproductive physiology, a condition that dialysis, despite improving survival in end-stage kidney disease (ESKD), cannot fully correct. As a result, pregnancies in this population are both uncommon and high-risk. Aims: We reported our center experience about pregnancy management in patients on hemodialysis: dealing with hypertension, ultrafiltration rate, dose dialysis in order to improve maternal and fetal outcome. Methods: We reported pregnancy outcomes of 12 cases recorded in the Tensift Region between March 2015 and July 2023. Maternal outcomes included preterm delivery, delivery by cesarean section, preeclampsia/eclampsia, length of stay at hospital (>3 days), and maternal death. Fetal outcomes included low birth weight (less than 2,500 g), small-for-gestational-age, admission to the neonatal intensive care unit, and infant mortality. Results: We reported 11 pregnant women cases on hemodialysis. Mean age of our patients was 27,8 (± 4,82) years. It was the first pregnancy for 4 patients (33,33%). The mean duration of pregnancy was 34,65(±4,66) weeks and mean fetal weight was 1,825(±0,57) kg. All patients were dialyzed over 20 hours per week, except for one who was unaware of the pregnancy and therefore dialyzed for only 12 hours per week for 24SA. The median urea value was 0,425 g/L. Four patients developed preeclampsia and needed anti-hypertensive drugs (33,33%). The overall live birth rate of our cohort was 75,7%. In our cohort we reported two fetal deaths at 21 SA and 26 SA explained by tocolysis failure for preterm labor and one neonatal death at D-3 post partum due to fetal growth restriction secondary to elevated urea levels. 4 newborns were admitted to the neonatal intensive care unit (NICU). Conclusion: While pregnancies in individuals on dialysis carry higher rates of adverse outcomes, Intensive, prolonged daily dialysis regimens are associated with improved maternal and fetal outcomes.