Acute renal failure in the obstetric population
Objectives: The objective of the study is to determine the aetiology and maternal outcome of acute renal failure in pregnancy and postpartum period. Methods: The study was conducted over a period of five years from August 2014 to July 2019. 38 previously healthy women who developed acute renal failure (ARF) during pregnancy or postpartum period were included in the study. Those with known renal disease, diabetes, chronic hypertension, history of renal calculi or urological intervention were excluded. The cases were followed up for a period of six months. Results: 38 patients with pregnancy related ARF were included. The age range was 18 to 39 years (mean 27±4.1years). 2(5.3%), 16(42.1%) and 20(52.6%) women were in the second trimester, third trimester and puerperal period respectively. The different aetiologies were preeclampsia 7(18.4%), antepartum haemorrhage 4(10.5%), postpartum haemorrhage 8(21%), puerperal sepsis 12(31.6%), intrauterine foetal death 3(7.9%), acute fatty liver of pregnancy 1(2.6%), hyperemesis gravidarum 1(2.6%) and septic abortion 2(5.3%). Maternal mortality was 5(13.2%). Of the 33(86.8%) women who survived, 17(44.7%) had complete recovery of renal function and 14(36.8%) had partial recovery. Conclusion: Pregnancy related ARF may have adverse maternal outcome. Approach to each clinical condition leading to it must be individualized and appropriate therapeutic decision is to be taken.