PPO.32 Audit of management and outcomes of obstetric patients with pre-existing renal disease managed in a specialist obstetric clinic

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Abstract

Objective

To audit a specialist antenatal clinic at St Mary’s hospital in managing obstetric patients with renal disease and evaluate pregnancy outcomes in those patients against set standards.

Methods

Data from patients with pre-existing renal disease managed in the clinic from January 2007 to December 2011 was included in the study. CKD staging was based on pre-conception eGFR or serum creatinine levels.

Results

117 singleton cases from 108 patients were analysed. Antenatal management standards had showed a satisfactory level with 1 in 4 women receiving a preconception advice, half of women starting prophylactic aspirin before 16 weeks with higher rate (65%) of prescribing in 2011. Pregnancy outcomes showed increased risk of pre-eclampsia development and preterm delivery along with Caesarean section compared to general population even with mild renal impairment. The highest rates of pregnancy complications were observed in severe renal impairment group with ¼ risk of not completing pregnancy.

Results

Aspirin prophylaxis showed some reducing effect on the development of PET in different groups compared to no aspirin prophylaxis.

Conclusion

There is a promising outlook in improvement of pregnancy outcomes in mild to moderate impaired kidney function pregnancies.

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