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Nephrology Dialysis Transplantation, Vol 14, Issue 6 1511-1516, Copyright © 1999 by Oxford University Press
H Toma, K Tanabe, T Tokumoto, C Kobayashi and T Yagisawa
Background: Since a report on the first successful
pregnancy of a woman on long-term haemodialysis in Japan in 1977, there has
been a growing number of case reports on successful pregnancy in patients
on dialysis. We undertook a nationwide survey on pregnancy in women on
renal replacement therapy in 1996. Methods: A
preliminary questionnaire was sent to 2504 dialysis units and 143 renal
transplant units in Japan. For each reported pregnancy, a more detailed
questionnaire was sent to collect nephrological, obstetric and neonatal
information. Results: There were 172 pregnancies
(0.44%) reported in 38 889 women on dialysis, with 90 successful
pregnancies (0.23%), and 194 pregnancies reported in 852 female renal
transplant recipients. Detailed pregnancy information was collected from 74
women on dialysis and 194 renal transplant recipients. Of the 74
pregnancies in the women on dialysis, 36 (48.6%) resulted in surviving
infants, nine (12.2%) in neonatal death, nine (12.2%) spontaneous abortions
and 14 (18.9% elective abortions were reported. The outcome of six
pregnancies (8.1%) was unknown. Of 194 pregnancies in renal transplant
recipients, 159 (82.0%) resulted in surviving infants, two (1.4%) in
neonatal death and 28 (14.4%) in spontaneous or elective abortion. In five
cases the pregnancy outcome was not reported. No congenital anomalies were
reported, except two infants with mental retardation and one with epilepsy.
Conclusion: The current survey revealed that the rate
of successful pregnancy in women on dialysis has improved. More than half
of the pregnancies resulted in infant survival. But, premature birth is a
major problem for the children of women on dialysis and there is a higher
rate of neonatal death. There are significant differences in gestational
age, birth weight, frequency and severity of prematurity and rates of
neonatal death between pregnancies of women undergoing dialysis and those
who are renal transplant recipients. Key words:
dialysis; pregnancy; renal transplantation
ORIGINAL ARTICLES
Pregnancy in women receiving renal dialysis or transplantation in Japan: a nationwide survey
Department of Urology, Kidney Centre, Tokyo Women's Medical College, Kawadacho 8-1, Shinjuku, Tokyo, 162-8666, Japan; Corresponding author
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