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Dialyse aktuell 2008; 12(5): 292-298
DOI: 10.1055/s-0028-1085087
Nephrologie

© Georg Thieme Verlag Stuttgart · New York

Dialyse und Schwangerschaft – Eine Fallserie von fünf Schwangeren unter intensivierter Dialyse

Dialysis and pregnancy – A series of five cases of pregnancy with intensified dialysisChristian Bamberg1 , Torsten Slowinski2 , Fritz Diekmann2 , John Hartung1 , Klemens Budde2 , Berthold Hocher2 , Horst Halle1 , Joachim W. Dudenhausen1
  • 1Klinik für Geburtsmedizin, Charité Universitätsmedizin Berlin, Campus Mitte (Direktor: Prof. Dr. Joachim W. Dudenhausen)
  • 2Medizinische Kliniken, Schwerpunkt Nephrologie, Charité, Campus Mitte, Humboldt Universität zu Berlin (Direktor: Prof. Dr. Hans–H. Neumayer)
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Publication History

Publication Date:
06 August 2008 (online)

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Dialysepflichtige Frauen werden selten schwanger. Fallberichte geben das fetale Outcome mit einer Lebendgeburtenrate zwischen 40 und 85 % an. Wir berichten von fünf dialysepflichtigen Schwangeren, die an unserem Perinatalzentrum betreut wurden. Alle Patientinnen erhielten ein standardisiertes, intensiviertes Dialyseprotokoll mit bis zu 7 Hämodiafiltrationen pro Woche mit einer mittleren Behandlungszeit von 28,6 ± 6,3 Stunden pro Woche. Der Behandlung lag ein multidisziplinärer Betreuungsansatz in Kooperation mit den Nephrologen und Neonatologen zugrunde. Supportiv erhielten die Patientinnen Erythropoetin, Vitamine und Spurenelemente. Ab der 26. Schwangerschaftswoche wurden alle Patientinnen stationär überwacht. Das mittlere Gestationsalter bei der Entbindung betrug 32,8 ± 3,3 Schwangerschaftswochen und die Neugeborenen waren im Mittel 1765 ± 554 g schwer. Die Lebendgeburtenrate betrug 100 %. Das fetale Outcome profitiert von einer qualifizierten, multidisziplinären Betreuung am Perinatalzentrum. Bei dialysepflichtigen Schwangeren sollte die Dialysedauer intensiviert werden und eine stationäre Betreuung im 2. Trimenon stattfinden.

Women subject to dialysis are rarely pregnant. Case reports have registered a fetal outcome of between 40 and 85 per cent live births. This is a report on five pregnant women subject to dialysis treated in our perinatal center. All these patients were subjected to a standardized intensified dialysis procedure with up to seven hemodiafiltrations weekly with an average treatment period of 28.6 +/– 6.3 hours weekly. A multidisciplinary care program was initiated in co–operation with the nephrologists and neonatologists. The patients supportingly received erythropoietin, vitamins and trace elements. Starting with the 26th week of pregnancy all patients were closely watched on an in–patient basis. The average gestation age at birth was +/– 3.3 pregnancy weeks and the average newborn weight was 1765 +/– 554 g. The live birth rate was 100 %. The fetal outcome benefited from a qualified multidisciplinary care program of the perinatal center. Pregnant women who are subjected to dialysis should be dialysed for a longer time and subjected to inpatient supervision from the second three–month term of pregnancy.

Key words

pregnancy - intensified hemodialysis - fetal surveillance - perinatal outcome

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Korrespondenz

Dr. Christian Bamberg

Klinik für Geburtsmedizin Charité, Campus Mitte

Charitéplatz 1

10117 Berlin

Email: christian.bamberg@charite.de

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