Abstract: PUB549
The First Case in Uzbekistan of Successful Pregnancy and Natural Birth in a Patient on Dialysis
Session Information
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Sharapov, Olimkhon Nadirkhanovich, Republican Specialized Scientific Practical Medical Center of Nephrology and Kidney transplantation, Tashkent, Uzbekistan
- Daminov, Botir, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
- Azizov, Sabit, Republican Specialized Scientific Practical Medical Center of Nephrology and Kidney transplantation, Tashkent, Tashkent, Uzbekistan
Introduction
Improvement of hemodialysis services in Uzbekistan, in particular the transition to single use of disposable dialyzers from reusable ones in 2019, has significantly improved the quality of life of dialysis patients. The reproductive system in these patients also improved as a result of this; one such patient experienced pregnancy and subsequent natural childbirth for the first time in the history of Uzbekistan.
Case Description
Patient A. 39 years old, with ESRD and a detected pregnancy of 18 weeks. History: 17 years ago, she fell ill with glomerulonephritis, has been receiving HD for 9 years. Obstetric history-has 1 normal birth and 1 abortion at 11 weeks. After experiencing nausea, vomiting, malaise and abdominal discomfort, she was sent for screening to determine if she was pregnant. Based on the results of two consecutive screenings, pregnancy was detected, 18 weeks, without pathologies and with progression. At 29-30 weeks of pregnancy, she was hospitalized. During the examination: BP-100/60 mmHg, HR-80 beats per minute, daily diuresis 2.0-2.5 liters. CBC: Hb-81, erythrocytes-2.7, leukocytes-8.5, platelets-192, ESR-63. Proteinuria-0.3. Blood: urea-6.9, creatinine-284, total protein-63, ferritin-2826.2, calcium-2.01, phosphorus 0.75, cholesterol-6.3, glucose-4.2, PTH-445.8 pg/ml, Vitamin D - 10.2 ng/ml. Hormones: Chorionic gonadotropin - 263240 mlU/ml, free estriol - 2.82. Tests for HIV, hepatitis B, C, and TORCH infections showed negative results. Ultrasound revealed moderate hepatomegaly, chronic cholecystitis, bile stagnation and bilateral shrinkage of both kidneys. On 09/07/2022, after hemodialysis session at 14:45 the patient was transferred to the maternity ward, at 16:50, a live premature boy was born, weighing 1554 g, length 42 cm, with an Apgar score of 5/7 points. A premature newborn corresponds to a gestational age of 29 weeks. After 5 days, she was discharged home. The child stayed in the neonatal pathology department. Incubator nursing, respiratory therapy NCPAP, treatment - Curasurf, antibacterial therapy (ampisul, merkacin) were carried out. After his condition improved, he was safely discharged home. Now, the health of mother and child is satisfactory. The child grows and develops.
Discussion
This case indicates that improving the quality of dialysis services improves the reproductive system of dialysis patients.