1994 Volume 27 Issue 10 Pages 1337-1342
A 34-year-old woman with ESRD (end-stage renal disease) who was maintained for over 12 years on regular hemodialysis had an 8-year hiltory of amenorrhea. At the patient's request infertility therapy was performed and conception was confirmed after 7 cycles of therapy with an ovulation stimulant. To prevent intrauterine growth retardation (IUGR) subsequent hemodialysis was scheduled 5 times per week (a total of 22.5 hours a week) to maintain her predialysis BUN level under 60mg/dl from the 8th gestational week until delivery. The patient's hematocrit level was maintained over 25% initially with blood transfusions and later by rHuEPO supplementation. At the 34th gestational week she was delivered of a 1, 580g boy by cesarean section. His Apgar score was 8 points. No abnormal findings were detected except for prematurity and a body weight low for gestational age. Although he has shown no abnormalities of mental development as of 3 years of age, he has a rather poor build and is within the lower limits of the standard deviation of Japanese children's physique. It will be important to carefully follow his future physical development. The patient has been in good health over the past 3 years, and the quality of her life has improved considerably.
On the basis of previous reports of 37 cases in Japan and of our own case, we discuss several essential conditions for successful pregnancy in long-term hemodialysis patients.
