Original Research Article
June 6, 2020
Clinical and Prognostic Aspects of Obstetric Acute Renal Failure in the Nephrology and Hemodialysis Department of the Point G Teaching Hospital in Mali
Fofana Aboubacar Sidiki, Yattara Hamadoun, Sy Seydou, Samaké Magara, Coulibaly Moctar, Coulibaly Sah dit Baba, Diallo Djénéba, Sima Mamadou, Sidibé Modi, Kodio Atabieme, Touré Alkaya, Coulibaly Nouhou
SAS J Med | 153-160
DOI : 10.36347/sasjm.2020.v06i06.001
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......