{"id":402,"date":"2023-07-25T10:44:50","date_gmt":"2023-07-25T10:44:50","guid":{"rendered":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/?page_id=402"},"modified":"2023-07-27T09:06:47","modified_gmt":"2023-07-27T09:06:47","slug":"high-risk-pregnancy-with-renal-problems","status":"publish","type":"page","link":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/high-risk-pregnancy-with-renal-problems\/","title":{"rendered":"High risk pregnancy with renal problems"},"content":{"rendered":"\t\t
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High risk pregnancy with renal problems<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Renal disease can affect the outcome of pregnancy, pregnancy can affect the progression of pre-existing renal disease, and pregnancy can itself cause renal impairment. The renal system undergoes significant physiological and anatomical changes during a normal pregnancy.<\/p>

Renal plasma flow increases by 50-70% in pregnancy (the change is most pronounced in the first two trimesters).<\/p>

There is an increased glomerular filtration rate (GFR), which peaks at about the 13th week of pregnancy and can reach levels up to 150% of normal.<\/p>

Therefore, both urea and creatinine levels are decreased.<\/p>

Increased levels of progesterone at the beginning of pregnancy increase relaxation of arterial smooth muscles and so decrease peripheral vascular resistance, causing a blood pressure fall of approximately 10 mm Hg in the first 24 weeks of pregnancy.<\/p>

A change in tubular function with increased glycosuria also occurs (see ‘Renal function in pregnancy’, below).<\/p>

The anatomical changes are mainly in the collecting system. A dilatation of the ureters and pelvis occurs, which can lead to urinary stasis and an increased risk of developing urinary tract infections (UTIs).<\/p>

There is also an increase in overall kidney size by about 1-1.5 cm.<\/p>

In general, the physiological changes peak by the end of the second trimester and then start to return to pre-pregnancy levels; anatomical changes generally take up to three months postpartum to subside.<\/p>

Renal function in pregnancy<\/h5>

Values considered normal when not pregnant may reflect decreased renal function in pregnancy. Creatinine above 75 \u03bcmol\/L and urea above 4.5 mmol\/L are indications for further investigation.<\/p>

The use of estimated glomerular filtration rate (eGFR) is not recommended in pregnancy.<\/p>

Glycosuria is common and does not usually indicate diabetes or impaired glucose tolerance.<\/p>

Urinary protein excretion increases during pregnancy, but never to more than 300 mg\/day and, therefore, overt proteinuria is abnormal.<\/p>

Women are at increased risk of UTI because of renal tract dilatation leading to urinary stasis.<\/p><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

High risk pregnancy with renal problems Renal disease can affect the outcome of pregnancy, pregnancy can affect the progression of pre-existing renal disease, and pregnancy can itself cause renal impairment. The renal system undergoes significant physiological and anatomical changes during a normal pregnancy. Renal plasma flow increases by 50-70% in pregnancy (the change is most… Continue reading High risk pregnancy with renal problems<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-402","page","type-page","status-publish","hentry","entry"],"_links":{"self":[{"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/pages\/402","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/comments?post=402"}],"version-history":[{"count":7,"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/pages\/402\/revisions"}],"predecessor-version":[{"id":683,"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/pages\/402\/revisions\/683"}],"wp:attachment":[{"href":"https:\/\/preview.coders.eternityindia.co.in\/kidneyhospital\/wp-json\/wp\/v2\/media?parent=402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}