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Maternal renal disease 

Maternal renal disease
Chapter:
Maternal renal disease
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0006
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date: 26 November 2020

This chapter deals with a wide range of maternal renal diseases including chronic renal disease (CKD), nephropathies, renal calculi, autosomal dominant polycystic kidney disease, pyelonephritis and autoimmune conditions leading to renal impairment. The impact of CKD on fertility/pregnancy is discussed. Individual fact files present the aetiopathology, epidemiology, symptomatology, diagnosis, and effects of the underlying renal condition on pregnancy and vice versa. Multidisciplinary care with nephrologists, pre-pregnancy assessment of disease severity and progression, antenatal monitoring of maternal renal function, proteinuria and hypertension, vigilance for superimposed pre-eclampsia, fetal assessments, timing of delivery and long-term nephrology follow-up are highlighted. The role of antihypertensives, immunosuppressants, low-dose aspirin, antenatal management, and planning intrapartum and postnatal care with specific reference to safety of drugs during breastfeeding and suitable contraception are presented. Integrated multidisciplinary management between primary, secondary, and tertiary settings is incorporated in individualized care pathways. Patient information is provided for various renal conditions.

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