대한신장학회

논문분류	춘계학술대회 초록집
제목	Pregnancy in Dialysis
저자	Enkhjin Sukhbaatar
출판정보	2025; 2025(1):
키워드	CKD-Chronic kidney disease, NCMCHM-National Center for Maternal and Child Health of Mongolia, TSCH-The Third State Central of Hospital
초록	Introduction: The first documented case of a pregnant woman undergoing hemodialysis was recorded in the 1970s. In 1990,the European Renal Association reported 16 deliveries from over 1300 women of reproductive age who were receiving dialysis in 19 countries worldwide. This presentation case marks the second instance in Mongolia of a pregnant woman on dialysis who successfully gave birth,providing a rationale for presenting this case. A Clinical case: O.T 35y/o Female Main complaint: Nausea,hypotension after undergoing dialysis,vagina hypertonic,headaches,parchment-skin. Obstetrics and Gynecology anamnesis: Pregnancy 3 times. In 2008,the first pregnancy resulted in a 4200gr baby boy by cesarean section due to birth asphyxia. In 2019 and 2021,she had two early miscarriages. In 2023, she had her fourth pregnancy and did not know when her menstruate,and her periods were an abnormal. Anamnesis Vitae: She was born in 1989. She regularly takes medications such as calcium acetate,foseal, vitamin D,and cinacalcet. She injects erythropoietin to subcutaneously. Her older sister was diagnosed with CKD in Sep.2023. Physical examination: Vital sign: BP-130/80 mmHg, HR- 90/min, t-36.5, RR-18, SpO2-96% General examination: Alert,oriented,mild dehydrated skin,paleness Dehydrated tongue (++) Abdomen: A fetus in utero. Urine output is low, about 600-1000ml per day,colorless and clear. Nocturia 2-3 times. DS: GN,CKDIII, Chronic dialysis, GrIV-III 34-35w. Conclusion: Women of reproductive age who have started renal replacement therapy, if there are no contraindications to rejection from other organ systems and have not given birth before, can continue their pregnancy even if they are undergoing hemodialysis at the request of the family. Therefore, if the patient is at risk of pregnancy, contraception should be advise with gynecologists and primary care doctors. In order to prevent pregnancy, monitoring, and complications during hemodialysis in pregnant women, it is considered of particular importance to work with nephrologists, obstetricians and gynecologists to develop guidelines and recommendations to prevent complications.
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