Kidney disease is not that common, but for a small percentage of women, it is something they must consider when planning to conceive. This may be despite their deteriorating kidney (or renal) function. Discussing your plans with your doctor before you conceive is ideal. If this is not possible (because the pregnancy was unplanned), seeing your doctor as soon as you find out you are pregnant is recommended.
Women with chronic renal disease should ideally be managed by a renal physician, in partnership with an obstetrician, throughout their pregnancy. The renal physician would focus on the kidney disease and any changes throughout the pregnancy, while the obstetrician oversees the pregnancy and birth care.
If the woman's renal impairment is mild, and she does do develop high blood pressure, the pregnancy should not cause any deterioration in the woman's renal function. For women who suffer from anaemia, high blood pressure, or protein in their urine, the risk of the
baby dying at some stage during the pregnancy can be as high as 60%.
Babies who do survive can experience placental insufficiency and be
small for dates. Induction of labour is usually advisable, once the baby is considered to be mature enough. However, if the woman is unwell, or the baby becomes distressed, this (or a Caesarean) may be recommended, even if the baby is premature. This may mean the baby will need to spend some time in the
intensive care nursery.
Women often find that their renal function has deteriorated after the birth, possibly resulting in the need for dialysis. Occasionally, the woman's kidneys can be damaged due to complications in the pregnancy, in some cases, affecting the woman's plans for future children. The complications can include extremely high blood pressure during the pregnancy or a major haemorrhage.
Information sources