Kate Bramham (Guy's and St Thomas' Hospital, London), Marian Knight (NPEU)
Severe maternal morbidity and mortality
Current pre-pregnancy advice given to women with Chronic Kidney Disease (CKD) Stage 5 is to delay conception until they receive a renal transplant, which is associated with restored fertility and improved pregnancy outcomes.
Women ineligible for prospective transplantation are counselled regarding high rates of fetal loss, severe preterm delivery, fetal growth restriction and small for gestational age infants, and maternal complications including pre-eclampsia.
Dialysis strategies are continually developing, however more intensive dialysis regimes are likely to be associated with treatment related complications (e.g.
infection, fluid volume shifts) which may have consequences for both mother and fetus.
Furthermore, the dialysis dose (urea clearance) has not yet been shown to be predictive of fetal outcome.
More information is needed about the intrauterine effects and neonatal consequences of changes in dialysis dose.
This project will collected information about pregnancy outcomes amongst women with CKD Stage 5 during pregnancy in the UK to assess the role of dialysis regimens and other factors in the outcomes of women and their infants.
Data analysis is currently underway.