Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Shipra Sudam Sonkusare
Accepted Abstracts: Pediatr Therapeut
Acute Renal Failure(ARF) in pregnancy can be very devastating, but fortunately rarewith incidence of less than 0.005%, though mild to moderate transient renal impairment is more common. In developing world, acute renal failure in pregnancy remains a common cause of maternal mortality.In the developed world, renal impaiement is much less dangerous than iatrogenic fl uid overload, particularly in the context of pre-eclampsia. Th e causes of renal failure in pregnancy include infection like septic abortion, puerperal sepsis, rarely acute pyelonephritis, blood loss as in postpartum haemorrhage or abruption placentae, volume contraction in pre-eclampsia, eclampsiaor hyperemesis gravidarum or post renal failure with ureteric damage or obstruction.Iatrogenic causes include use of non steroidal anti-infl ammatory drugs or antibiotics. In many of these conditions, there is an associated coagulopathy. Th e commonest cause of ARF in the context of pre-eclampsia is HELLP syndrome( about 50%). Most of the times, the underlying cause of ARF is obvious as in abruption or post-partum haemorrhage.However, blood loss may not be recognized or may be underestimated and the diagnosis only upon the fi nding of low central venous pressure.Management depends upon the underlying cause, but in all cases, accurate assessment of fl uid balance with urinary catheter and central venous pressure line, is essential. Measurement of fl uid input and output should be made hourly. Any associate coagulopathy must be corrected.Th e treatment of pre-renal failure is adequate replacement of blood and fl uid losses.Diuretics should be avoided until volume depletion has been corrected.Acute tubular necrosis is reversible and supportive management should be continued.
Dr. Shipra S Sonkusare has done her MD at the age of 26 in the fi eld of Obstetrics & Gynaecology from PGIMER, Chandigarh, India. She was All India Science topper in CBSE board, India and has done her graduation and postgraduation from apex Institutes of India. She has several international presentations and publications to her credit and has won the Best Journal Paper Prize 2007 in junior category awarded by the Federation of Obst. & Gynae Society of India. She is currently working as Associate Professor at Manipal University.