Renal Challenges in Pregnancy: Investigating Acute Kidney Failure and Perinatal Well-beingA Prospective Descriptive Study

Abstract

Introduction: Acute Kidney Injury (AKI) poses life-threatening risks in pregnancy, leading to adverse perinatal and maternal outcomes. Aim: To estimate the incidence of Pregnancy-Related Acute Kidney Injury (PRAKI) and describe maternal and foetal outcomes in cases of Acute Renal Failure (ARF) at a tertiary care institute. Materials and Methods: A prospective descriptive study was conducted on 104 antenatal women with ARF attending King George Hospital, Visakhapatnam, Andhra Pradesh, India, from January to December 2020. A total of 7,409 deliveries occurred during the study period, and antenatal women with evidence of pre-existing renal disease were excluded. A detailed history was obtained, and evaluation included renal function tests and a total abdominal scan. Mode of delivery, foetal deaths, stillbirths, maternal deaths, and APGAR scores were analysed. Laboratory findings were also reported. Data analysis was performed using coGuide statistical software, and results were expressed in terms of frequency and percentages. Results: The incidence of PRAKI was 14 per 1,000 deliveries (1.4%). The mean age of the participants was 24.05±4.11 years. The majority (78 out of 104, 75%) were in the third trimester. Out of the 104 cases of PRAKI, 77 (74%) were due to hypertension. There were 16 (15.4%) maternal deaths and 19 (21.8%) perinatal deaths. Conclusion: Pregnant women with ARF experienced increased morbidity and mortality. Urgent improvements in antenatal care, early detection of complications, effective management, and timely referrals to tertiary centres are crucial.