Pregnancies are exceedingly rare in dialysis patients, while the rate of successful pregnancies has grown over time, reaching more than 70% in certain studies. These pregnancies are not without issues for both the mother and the foetus, which require the expertise of a nephrologist in Ludhiana, a gynaecologist, a nurse, and a nutritionist.
Longer gestational periods are known to increase the weight of newborns, enhance their odds of surviving, and reduce long-term issues.
The amount of total weekly dialysis time recommended varies depending on the studies, but regardless of the standards used, the hemodialysis prescription must be sufficient to maintain stable maternal condition in terms of blood volume, blood pressure, and blood pressure gain, as well as weight between sessions.
Nocturnal hemodialysis would have the following benefits: increased clearance of small and medium-sized molecules; improved management of blood pressure, metabolic, electrolytic, phosphorous, and volemia profiles.
A relatively small number of patients have experience with peritoneal dialysis in pregnant women; in fact, these patients had a lower pregnancy incidence than those receiving hemodialysis. This could be as a result of hypertonic solutions being present in the peritoneum, past bouts of peritonitis, or physical barriers to foetal implantation. After conception, the majority of publications advise against changing the dialysis mode.
The multidisciplinary approach, increasing dialysis time, maintaining low pre-dialysis urea levels, attempting to prevent prematurity, strictly controlling blood pressure and electrolytes, avoiding urinary infections, and adequate foetal monitoring are among the methods mentioned in the various publications to help these patients have successful pregnancies.