International Journal of Midwifery Nursing And Practices Review Article
Pregnancy Outcomes on Chronically Hemodialyzed Women in Arab World: A Systematic Review
Abstract
Pregnancy carries a major risk of difficulties, as highlighted by the present systemic study on pregnancy outcomes in persistently hemodialyzed women in the Arab world. The objective of this systematic review was to describe the pregnancy outcomes among chronically hemodialyzed pregnant women in Arab countries in terms of the incidence of pregnancy among women on maintenance hemodialysis and the incidence of maternal and fetal complications of pregnant women on hemodialysis. A systematic review was performed based on PRISMA guidelines. Data searches were conducted through databases such as MEDLINE, and Scopus, and manual search of multiple databases. 11 studies met the inclusion criteria after applying a filtering approach, which was ready for analysis. Results indicated that the included studies reported 302 pregnancies with a success rate of 43.4%. The mean yearly incidence rate of pregnancy among women was 1.12%. The most common complications reported were abortion for mothers and IUFR for fetuses (7.7%). The main recommendation was to increase the duration and the frequency of HD, as it is reported in four articles to be associated with a higher success rate with statistical significance (p-value<0.05).
Keywords
References (36)
- Souqiyyeh MZ, Huraib SO, Mohd. Saleh AG, Aswad S. Pregnancy in Chronic Hemodialysis Patients in the Kingdom of Saudi Arabia. American Journal of Kidney Diseases. 1992;19(3):235-238. doi:10.1016/s0272-6386(13)80003-0
- Oliverio AL, Hladunewich MA. End-Stage Kidney Disease and Dialysis in Pregnancy. Advances in Chronic Kidney Disease. 2020;27(6):477-485. doi:10.1053/j.ackd.2020.06.001
- Zhang JJ, Ma XX, Hao L, Liu LJ, Lv JC, Zhang H. A Systematic Review and Meta-Analysis of Outcomes of Pregnancy in CKD and CKD Outcomes in Pregnancy. Clinical Journal of the American Society of Nephrology. 2015;10(11):1964-1978. doi:10.2215/cjn.09250914
- Wiles KS, Nelson-Piercy C, Bramham K. Reproductive health and pregnancy in women with chronic kidney disease. Nature Reviews Nephrology. 2018;14(3):165-184. doi:10.1038/nrneph.2017.187
- Herwig KR, Merrill JP, Jackson RL, Oken DE. Chronic renal disease and pregnancy. American Journal of Obstetrics and Gynecology. 1965;92(8):1117-1121. doi:10.1016/s0002-9378(15)33094-5
- Orme BM, Ueland K, Simpson DP, Scribner BH. The effect of hemodialysis on fetal survival and renal function in pregnancy. Trans Am Soc Artif Intern Organs. 1968; 14: 402–404.
- Ackrill P, Goodwin FJ, Marsh FP, Stratton D, Wagman H. Successful pregnancy in patient on regular dialysis. BMJ. 1975;2(5964):172-174. doi:10.1136/bmj.2.5964.172
- Sivasuthan G, Dahwa R, John GT, Ranganathan D. Dialysis and Pregnancy in End Stage Kidney Disease Associated with Lupus Nephritis. Case Reports in Medicine. 2013;2013:1-7. doi:10.1155/2013/923581
- Copur S, Berkkan M, Basile C, Cozzolino M, Kanbay M. Dialysis in Pregnancy: An Update Review. Blood Purification. 2023;52(7-8):686-693. doi:10.1159/000531157
- Chan WS, Okun N, Kjellstrand CM. Pregnancy in Chronic Dialysis: A Review and Analysis of the Literature. The International Journal of Artificial Organs. 1998;21(5):259-268. doi:10.1177/039139889802100503
- Tangren J, Nadel M, Hladunewich MA. Pregnancy and End-Stage Renal Disease. Blood Purification. 2018;45(1-3):194-200. doi:10.1159/000485157
- Page MJ, McKenzie JE, et al. The PRISMA 2020 statement. An updated guideline for reporting systematic reviews. PLOS Med. 2021; 18(3): 1003583.
- Doukkali B, Bahadi A, Rafik H, Kabba D, Benyahia M. La grossesse chez les hémodialysées chroniques. Pan African Medical Journal. 2015;20. doi:10.11604/pamj.2015.20.213.6196
- Bahadi A, El Kabbaj D, Guelzim K, Kouach J, Hassani M, Maoujoud O, Aattif M, Kadiri M, Montassir D, Zajjari Y, Alayoud A, Benyahia M, Elallam M, Oualim Z. Pregnancy during hemodialysis: A single center experience. Saudi J Kidney Dis Transplant: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia. 2010; 21(4): 646–651. Scopus.
- Hadj Sadek B, Kejji S, Rhou H, Ezzaitouni F, Ouzeddoun N, Bayahia R, Benamar L. [Pregnancy in chronic hemodialysis patients]. J Gynecol Obstet Biol Reprod. 2011; 40(5): 452–459. https://doi.org/10.1016/j.jgyn.2011.04.003
- Sulaiman, Ibrahim. Pregnancy in Hemodialysis Patients. Saudi J Kidney Dis and Trans. Jan–Mar 1997; 8(1): 32–35.
- Chaker H, Masmoudi S, Toumi S, Dammak N, Hachicha J, Kammoun K, Yaich S, Hmida MB. [Pregnancy in patients on chronic haemodialysis: About 25 cases which occurred in the south of Tunisia]. Pan Afr Med J. 2020; 36: 195. https://doi.org/10.11604/pamj.2020.36.195.20514
- Malik G, Al-Harbi A, Al-Mohaya S, Dohaimi H, Kechrid M, Al-Hassan AO, Quiapos LS. Pregnancy in Patients on Dialysis—Experience at a Referral Center. J Assoc Physicians India. 2005 Nov; 53: 937–41.
- Megahed AF, Kannishy GE, Azawy HE, Megahed HF, Hashish EH, Ahmed NS. Pregnancy Outcomes in Egyptian Women on Maintenance Hemodialysis: A Multicenter Observational Study. Asian Journal of Medicine and Health. 2020:1-17. doi:10.9734/ajmah/2020/v18i1030247
- Abd KH, Al-Shamma I. Successful pregnancy in a patient with hemodialysis in Iraq. Saudi J Kidney Dis Transpl. 2007 Jun;18(2):257-60.
- Imtiaz S, Shams M, Albably SAR, Khan AS. Successful pregnancy in end-stage renal disease patient in a sub-urban area of Saudi Arabia. Saudi J Kidney Dis Transplant. 2008; 19(6): 980–2.
- Iqbal T, Aborahma AM, Kanaan A, Ahmed AA, Ali AZ, Al-Lehbi AM. Outcome of Pregnancy in Chronic Hemodialysis Patients: Single Center Experience. Acta Scientific Clinical Case Reports (ASCR). 2022; 3(8): 03–07.
- Ribeiro CI, Silva N. Pregnancy and dialysis. Brazilian Journal of Nephrology. 2020;42(3):349-356. doi:10.1590/2175-8239-jbn-2020-0028
- Baouche H, Jais JP, Meriem S, Kareche M, Moranne O, Vigneau C, et al. Pregnancy in women on chronic dialysis in the last decade (2010–2020): a systematic review. Clinical Kidney Journal. 2022;16(1):138-150. doi:10.1093/ckj/sfac204
- Chakhtoura Z, Meunier M, Caby J, Mercadal L, Arzouk N, Barrou B, et al. Gynecologic follow up of 129 women on dialysis and after kidney transplantation: a retrospective cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;187:1-5. doi:10.1016/j.ejogrb.2015.01.004
- Hirano H, Ueda T, Tani H, Kosaka K, Nakatani E, Hawke P, et al. Pregnancy and delivery in women receiving maintenance hemodialysis in Japan: analysis of potential risk factors for neonatal and maternal complications. Journal of Nephrology. 2021;34(5):1599-1609. doi:10.1007/s40620-021-01146-3
- Piccoli GB, Attini R, Vasario E, Conijn A, Biolcati M, D'Amico F, et al. Pregnancy and Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology. 2010;5(5):844-855. doi:10.2215/cjn.07911109
- Piccoli GB, Cabiddu G, Daidone G, Guzzo G, Maxia S, Ciniglio I, et al. The children of dialysis: live-born babies from on-dialysis mothers in Italy--an epidemiological perspective comparing dialysis, kidney transplantation and the overall population. Nephrology Dialysis Transplantation. 2014;29(8):1578-1586. doi:10.1093/ndt/gfu092
- Yang LY, Thia EWH, Tan LK. Obstetric outcomes in women with end-stage renal disease on chronic dialysis: a review. Obstetric Medicine. 2010;3(2):48-53. doi:10.1258/om.2010.100001
- Manisco G, Potì’ M, Maggiulli G, Di Tullio M, Losappio V, Vernaglione L. Pregnancy in end-stage renal disease patients on dialysis: how to achieve a successful delivery. Clinical Kidney Journal. 2015;8(3):293-299. doi:10.1093/ckj/sfv016
- Al-Matary A, Ali J. Controversies and considerations regarding the termination of pregnancy for Foetal Anomalies in Islam. BMC Medical Ethics. 2014;15(1). doi:10.1186/1472-6939-15-10
- Shehaj L, Kazancıoğlu R. Pregnancy in Chronic Kidney Disease. Kidney and Dialysis. 2023;3(2):152-162. doi:10.3390/kidneydial3020013
- Bas Lando M, Urman M, Weiss Y, Srebnik N, Grisaru-Granovsky S, Farkash R, et al. Term Idiopathic Polyhydramnios, and Labor Complications. Journal of Clinical Medicine. 2023;12(3):981. doi:10.3390/jcm12030981
- Luders C, Titan SM, Kahhale S, Francisco RP, Zugaib M. Risk Factors for Adverse Fetal Outcome in Hemodialysis Pregnant Women. Kidney International Reports. 2018;3(5):1077-1088. doi:10.1016/j.ekir.2018.04.013
- Strippoli GFM. Sexual Dysfunction in Women with ESRD Requiring Hemodialysis. Clinical Journal of the American Society of Nephrology. 2012;7(6):974-981. doi:10.2215/cjn.12601211
- Zha Y, Qian Q. Protein Nutrition and Malnutrition in CKD and ESRD. Nutrients. 2017;9(3):208. doi:10.3390/nu9030208