Title, Author and Year

Objective

Methodology

Results

Pregnancy outcomes in hemodialysis patients in France.

Normand, et al., 2018 [9].

To describe the maternal characteristics

and risk factors associated with maternal and fetal

maternal and fetal outcomes.

Descriptive, retrospective, multicenter study. Pregnant women on hemodialysis during the period 1985 to 2015 in France were included.

It revealed that the benefit of increased hemodialysis sessions in pregnancy was confirmed through higher mean birth weight (2,400 g) and an increased fetal survival of 85%. The mean duration of dialysis per week was 18 ± 4.2 hours, while at least 20 hours of dialysis per week are associated with significantly improved fetal outcomes. Given the apprehended results, increased hemodialysis sessions during pregnancy contributed in 85% of women to fetal survival. This was more than 36 hours of hemodialysis per week compared to 48% of those with lower income who received 20 hours of dialysis.

Obstetric deliveries in US women with Chronic Renal Insufficiency: 2002-2015

Oliverio, et al., 2020 [6].

To describe long-term trends in obstetric deliveries among women with chronic kidney disease in the United States and to investigate the association of treatment modalities (hemodialysis, peritoneal dialysis, and transplantation) and other clinical characteristics with delivery outcomes, including premature delivery and cesarean section.

We conducted a retrospective cohort study of all female CKD patients between January 1, 2002 and September 30, 2015, using data from the United States Renal Data System (USRDS).

It showed a 71% increase in the birth rate among women of childbearing age on hemodialysis during the study period. It was found that although the average number of hemodialysis minutes prescribed increased slightly in the 9 months prior to delivery, only a minority of women received more than 1,200 minutes of hemodialysis per week in their outpatient hemodialysis units. In addition, birth rates increased from 2.1 to 3.6 per 1,000 patient-years and from 3.1 to 4.6 for women who received hemodialysis and those who received renal transplantation, respectively. And, the mean age at delivery increased from 29.1 years in 2002 to 31.9 years in 2015 during the study period. Among mothers, 81.8% preferred hemodialysis, 12% preferred peritoneal dialysis, 5.9% transplanted first, and the remaining 0.3% had an unknown first choice. Thus, those receiving peritoneal dialysis had lower chances of delivery, and older age was also associated with lower chances of delivery, with a 41% rate of premature delivery.

Black women on chronic kidney dialysis were more likely to have a premature birth than white women, and noted that 50.6% of transplant recipients gave birth by C-section.

Pregnancy in chronic hemodialysis: about 25 cases occurring in southern Tunisia.

Chaker, et al., 2020 [10].

To report the experience on the occurrence of pregnancy in dialysis patients and identify the factors involved in its success.

A retrospective study of 25 spontaneous pregnancies that occurred in 19 patients treated with periodic hemodialysis in southern Tunisia over a period of 34 years.

It was noted that with adequate support and especially increasing the number of dialysis sessions, maternal-fetal complications can be minimized.

Sixteen hours of dialysis per week was scheduled, which occurred in 7 cases and 20 hours per week, resulting in newborn survival and a mean gestational age of 34 weeks. Analysis shows that there is a significant correlation between increases in weekly dialysis time and gestational success rate (R = 0.59; p = 0.002).

Pregnancy and its outcomes in hemodialysis patients in Turkey.

Dheir, et al., 2021 [11].

Investigate the frequency of pregnancy and assess factors affecting live births in hemodialysis patients.

Female hemodialysis patients whose pregnancy was reported retrospectively between January 1, 2014 and December 31, 2019.

The results of pregnancy in female patients on hemodialysis, showed that increasing the number of hemodialysis sessions decreases fetal and maternal complications and increases live birth rates.

The miscarriage rate was 22.4% in the group of women who had more hemodialysis sessions, compared to those who had fewer hemodialysis sessions who had a 79.3% miscarriage rate. In a dialysis 5 times a week was correlated with better.