Pregnancy in women with end-stage renal disease: treatment of anemia and premature labor

Am J Kidney Dis. 1993 Jan;21(1):16-22. doi: 10.1016/s0272-6386(12)80714-1.

Abstract

There is little experience with the use of various therapies in the end-stage renal disease patient who becomes pregnant. Erythropoietin for the treatment of anemia has become part of the standard treatment regimen of dialysis patients, but experience with its use in pregnancy is limited. We report five cases of its use in dialysis patients during pregnancy. We found no evidence that it crossed the placenta or that it made blood pressure control more difficult. We found that patients required a higher dose of erythropoietin to maintain hematocrit levels than they had before pregnancy. Another therapy involves the treatment for premature labor, which is the most common cause of pregnancy loss in dialysis patients. Two of our patients were successfully treated with indomethacin for premature labor. Both drugs are useful tools in the management of pregnant dialysis patients.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Drug-Induced
  • Adult
  • Anemia / drug therapy*
  • Anemia / etiology
  • Erythropoietin / adverse effects
  • Erythropoietin / therapeutic use*
  • Female
  • Hematocrit
  • Humans
  • Hypertension / chemically induced
  • Indomethacin / adverse effects
  • Indomethacin / therapeutic use
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / therapy
  • Obstetric Labor, Premature / complications
  • Obstetric Labor, Premature / drug therapy*
  • Obstetric Labor, Premature / etiology
  • Oligohydramnios / chemically induced
  • Polyhydramnios / complications
  • Polyhydramnios / drug therapy
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy*
  • Pregnancy Complications, Hematologic / etiology
  • Pregnancy Outcome
  • Renal Dialysis

Substances

  • Erythropoietin
  • Indomethacin