What should kidney disease patients pay attention to during pregnancy? Just read this article

Compared with ordinary pregnant women, the risks to both pregnant women and fetuses of patients with chronic kidney disease are significantly increased during pregnancy. Therefore, patients with any symptoms of chronic kidney disease should not be taken lightly during pregnancy. Improving the quality of pregnancy care for patients with chronic kidney disease and increasing the intensity and strength of pregnancy monitoring can effectively reduce the maternal mortality rate of chronic kidney disease and increase the survival rate of the fetus. For expectant mothers with chronic kidney disease, in addition to strengthening routine pregnancy care, the following two aspects should also be achieved.

Fully understand pregnancy health care knowledge

Patients with chronic kidney disease are at a significantly higher risk of developing pregnancy-induced hypertension, preeclampsia, eclampsia, low birth weight, premature birth, and intrauterine growth retardation than ordinary pregnant women. Therefore, patients with kidney disease should be more aware of pregnancy health care knowledge and pay more attention to lifestyle adjustments. (1) Ensure adequate rest and sleep. (2) Eat a reasonable diet to ensure adequate nutrition. Generally, there is no need for special dietary taboos. Follow the principle of a "light, nutritious" balanced diet. If edema and high blood pressure occur, salt and water intake should be limited to prevent edema from worsening. In addition, attention should be paid to supplementing sufficient vitamins to strengthen the body and reduce the chance of infection. (3) Pay attention to keeping warm and prevent colds.

Strengthen outpatient follow-up of obstetrics and gynecology and nephrology departments

01In the early stages of pregnancy (from the beginning to the 12th week), it is recommended to have a follow-up visit once a month. In addition to routine obstetrics and gynecology examinations, urine routine and renal function tests should be performed monthly.

02Mid-pregnancy (13-28 weeks) During this period, patients with kidney disease are prone to increased urine protein, high blood pressure, and edema. Doctors will strengthen the monitoring of pregnant women's renal function, urine protein, and blood pressure, and pay close attention to changes in pregnant women's kidney disease so as to detect and treat them in time. In addition to monitoring the fetal heart rate and uterine height, doctors will also use B-ultrasound to carefully check whether the size of the fetus and the composition of various parts are normal, and conduct a systematic assessment of the growth and development of the fetus. It is recommended to follow up once every two weeks. If there are changes in blood pressure and renal function, the monitoring frequency should be increased.

Pregnancy-induced hypertension syndrome (PIH) is the most common complication during this period. It is a general term for a series of symptoms such as high blood pressure, edema, and proteinuria that occur after 5 months of pregnancy. The probability of PIH in pregnant women with kidney disease is significantly increased, and the onset time may be earlier, so it should be closely monitored. In addition to the doctor's routine blood pressure measurement every two weeks, if conditions permit, you can test it at home.

03 Late pregnancy (last 12 weeks) This period is the most prone to pregnancy-induced hypertension, preeclampsia and eclampsia. As the fetus develops, the burden on the kidneys continues to increase, so it is best to follow up once a week, closely monitor the occurrence of hypertension, and actively treat hypertension in pregnant women. After 32 weeks of pregnancy, you should go to the hospital for a check-up once a week. If a pregnant woman with chronic kidney disease changes her condition in the second half of pregnancy, she should be hospitalized at any time to closely observe changes in renal function and fetal growth and development, and deal with it in a timely manner, strive to get a live baby and ensure the safety of the mother. If there is a clear trend of increasing blood pressure and a rapid decline in renal function in a short period of time, the pregnancy should be terminated in time.

If the pregnancy progresses smoothly and the kidney disease is stable, delivery can be handled the same as normal pregnancy. Generally, when the pregnancy of a kidney disease patient lasts to 36 weeks, termination of pregnancy can be considered according to the condition. At this time, the fetus is mature, and delivery can get the fetus out of the adverse environment as soon as possible, while also avoiding aggravating the kidney damage of the pregnant woman.

summary

In short, when pregnant, patients with chronic kidney disease should improve their self-care ability and health awareness, and should strengthen monitoring throughout the pregnancy. In addition to strengthening the growth and development of the fetus and heart rate monitoring, they should also visit the nephrology clinic regularly, closely observe the impact of pregnancy on the mother's renal function and blood pressure, and minimize the risk of worsening kidney disease in pregnant women, creating the best internal living environment for the baby.