Renal failure during pregnancy

Introduction: Acute renal failure in obstetric intensive care units is a diagnostic and therapeutic emergency. It is defined by the elevation during pregnancy of serum creatinine to ≥ 1 mg/dL or a rapid increase (in 48 h) of 0.5 mg/dL above the baseline value.

The aim of our study is to describe the cases of renal failure, as well as to identify the factors associated with a poor prognosis.

Patients and methods: This is a retrospective, descriptive and analytical study, covering a period of 3 years, from January 2021 to December 2023. It was carried out in the obstetric intensive care unit of the Mohammed VI University Hospital Center in Marrakech.

Results: Ninety-nine patients were collected during the study period. The mean age of the patients was 30.55 ± 6.47 years (19 to 47 years). AKI in obstetric intensive care occurred more frequently in multigravida (73.8%) and multiparous (68.7%) patients. The etiologies of AKI in obstetric intensive care were, in order of frequency: pre-eclampsia (43.4%) and its complications, hemorrhagic shock (13.1%), acute hepatic steatosis during pregnancy (6.1%). The evolution was favorable with total recovery of renal function in 51.51%. While 37.3% of patients with partial recovery. Chronic kidney disease was observed in 3 patients. We also noted 2 maternal deaths.

Conclusion: ARF in obstetric intensive care remains common in developing countries (4.2-15%). Pre-eclampsia, HELLP syndrome, eclampsia, hemorrhagic shock and sepsis represent its main etiologies