DOI: 10.36347/sasjm.2020.v06i06.001

Pages: 153-160

Introduction: Acute kidney injury (AKI) remains a serious and frequent complication in developing countries. Objective: To evaluate the clinical and evolutionary profile of patients hospitalized for acute obstetric renal failure in the nephrology department of the Point G teaching hospital in Mali. Patients and methods: This was a prospective and descriptive study from June 1, 2015 to June 1, 2019. Results: The prevalence of obstetrical AKI in the nephrology department of the Point G teaching hospital was 2.08%. The majority of AKI occurred postpartum 61 cases versus 2 cases during pregnancy after the 20th week of amenorrhea. The mean age of the patients was 27.31 ± 5.49 years. Blood pressure was normal in 30.2% of participants. According to the WHO classification of hypertensive patients, hypertension grade 2 was found in 36.5% of cases followed by grade 3 and 1 (17.5% and 15.9%). The average blood pressure was 150.39 / 98.68 mmHg. The haemogram objectified severe anaemia in thirty-five patients. The causes of AKI were severe preeclampsia (55.5%), postpartum hemorrhage (36.5%), post-clandestine abortion sepsis (3.2%), severe Palsmodium falciparum malaria (1.6%), severe superimposed preeclampsia (1.6%) and hemolytic uremic syndrome (1.6%). Forty-six patients were dialysed, i.e. 73%. During their follow-up, total recovery of renal function was observed in 67.9% (31 cases) versus 1 case of partial recovery, 4 patients progressed to end-stage chronic renal failure, 7 cases of death were observed and 3 cases of discontinuation of follow-up. Among the non-dialysis patients, recovery of ad-integrum renal function was observed in 16 patients and 1 case of death. Maternal and perinatal mortality was 12.69% and 41.2% of cases. Conclusion: Obstetric AKI remains common in Africa. Screening for renal impairment during pregnancy should be routine. We insist on primary prevention of obstetrical complications, decentralization of dialysis centers, close collaboration between......