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Research Paper | Obstetrics and Gynecology | India | Volume 11 Issue 11, November 2022 | Popularity: 4.9 / 10
Acute Kidney Injury in Pregnancy and Puerperium- A Prospective Observational Study in a Tertiary Care Institute
Dr. R. Rajarajeswari, Dr. Uma Brindha .J, Dr. J. Vaishnavi
Abstract: Background: Even though incidence of AKI in pregnancy is decreasing in developing countries, it still accounts for 5%?20% of total AKI population. Preeclampsia, Postpartum hemorrhage, sepsis and placental abruption are the leading cause of AKI in pregnancy. The aim of this study is to analyse the level of mortality and morbidity due to AKI in pregnancy and the need to prevent this avoidable complication by early detection of at risk individual. Methods: In the present study conducted at Thanjavur Medical college and Government Raja Mirasudhar Hospital, out of all patients who attended Obstetrics and Gynaecology department OPD over a period of 18 months, 76 cases had AKI. These patients were studied in detail to know about the Incidence, characteristics, morbidity and mortality. Results: Incidence of AKI in this study is 4 per 1000 deliveries. AKI is common in Postpartum period (60.52%). More in multigravida (63.15%). The commonest etiology is Hypertensive disorders (59.21%), followed by PPH(15.7%) and sepsis (14.4%). 61.8% patients with transient renal impairment recovered with conservative management and 15.7% cases had undergone hemodialysis. Recovery rate among dialysis patient is 75%. The mortality rate in our study is 26.3%. Perinatal mortality is 21%. Conclusion: Decreasing incidence of PR-AKI have been noted in this study, mainly due to decreased incidence of postabortal AKI. Preeclampsia and sepsis, both are treatable and preventable etiologies. Timely intervention of Postpartum hemorrhage with adequate fluid replacement and blood transfusion will prevent the renal hypoperfusion thereby preventing AKI. Hence patient at risk should be identified and properly monitored to prevent the patient from worsening of general condition.
Keywords: Acute kidney injury, severe preeclampsia, postpartum hemorrhage, septic abortion, renal replacement therapy, hemodialysis, early diagnosis and intervention, maternal mortality, perinatal mortality
Edition: Volume 11 Issue 11, November 2022
Pages: 197 - 200
DOI: https://www.doi.org/10.21275/MR221030110725
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