Two successive pregnancies in a patient during 14 years of hemodialysis: a case report

BACKGROUND The incidence of pregnancy in women with end-stage renal disease seems to be increasing. Improvements in dialysis, obstetrical care, and antenatal fetal monitoring over the past two decades appear to have increased fertility rates and successful pregnancies in dialysis-dependent women. A pregnancy with a successful outcome despite the long dialysis period, as in the patient described here, is very rarely reported in the literature. CASE PRESENTATION I report a case of a 34-year-old white Kurdish woman who had had two uncomplicated pregnancies while on hemodialysis, with delivery of healthy babies. The first pregnancy occurred in the eighth year of her hemodialysis and ended in the 32nd week of gestation with healthy vaginal delivery of a 1900-g baby. The second pregnancy occurred in the 14th year of her hemodialysis and ended in the 30th week of gestation, with vaginal delivery of a 1400-g baby. The second baby, who had respiratory problems, was discharged after 45 days of intensive care. CONCLUSIONS Although pregnancy during the hemodialysis is risky, the outcomes of the pregnancies could be improved by an intensive hemodialysis regimen, appropriate anemia management, strict blood pressure follow-up, and correct evaluation of the dry weight.