Muhammad Abdul Mabood Khalil, Amer Azhar, Nisar Anwar, Amin ullah, Najm -ud- Din, Raj Wali


Background: Acute renal failure is a serious complication in pregnancy. Not only does it result in
significant maternal morbidity and mortality but also results in significant number of foetal loss.
Although incidence of obstetrical acute renal failure has decreased in developed countries but still it
is one of the major health problem of developing nations. The objective of this study was to study
aetiology, maternal and foetal outcome in obstetrical acute renal failure. Methods: This study was
conducted at Department of Nephrology, Khyber Teaching Hospital, Peshawar from August 2006 to
December 2007. It was a descriptive, case series study. Female patients with pregnancy and acute
renal failure, irrespective of age, were included in the study. Patients were thoroughly examined and
baseline urea, creatinine, serum electrolytes, peripheral smear, prothrombin time, partial
thromboplastin time, fibrinogen degradation products, renal and obstetrical ultrasound were
performed on each patient and 24-hr urinary protein and bacterial culture sensitivity on blood, urine
or vaginal swabs were done in selected patients. Foetal and maternal outcome were recorded. Data
were analysed using SPSS. Results: A total of 60 patients were included in the study. Mean age of
the patients was 295.4 years and duration of gestation was 334.9 weeks. Mean gravidity was
42.2. Sixteen patients (26.66%) were treated conservatively while 44 (73.33%) required dialysis.
Postpartum haemorrhage was present in 14 (23.33%), postpartum haemorrhage and disseminated
intravascular coagulation (DIC) in 11 (18.33%), eclampsia-preeclampsia in 8 (13.33%), antepartum
haemorrhage in 8 (13.33%), antepartum haemorrhage with DIC in 6 (10%), DIC alone in 4 (6.66%),
obstructed labour in 3 (5%), septic abortion in 3 (3.33%), HELLP (haemolysis elevated liver enzyme
and low platelet) in 2 (3.33%), urinary tract infection with sepsis in 1 (1.66%) and puerperal sepsis in
1 (1.66%). Foetal loss was 40 (66.66%). Maternal mortality was 9 (15%) while 28 (46.66%) fully
recovered. Among the rest 6 (30%) had partial recovery and 5 (8.33%) had dialysis dependent
chronic kidney disease. Conclusion: Obstetrical acute renal failure not only results in foetal loss but
also causes significant maternal morbidity and mortality.
Keywords: Obstetrical acute renal failure, ARF, Aetiology, Foetal outcome, Maternal outcome

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Lameire, Van Biesen W, Vanholder R. Acute renal failure.

Lancet 2005;365:417–30.

Agraharkar M, Agraharkar A, Kelly B, Mandayam AS,

Baweja K. Renal disease and pregnancy. [online] 2006 [cited

May 10]. Available from

med/topic 3253.htm

Drakeley AJ, Le Roux PA, Anthony J, Penny J. Acute renal

failure complicating severe preeclampsia requiring admission

to an obstetric intensive care unit. Am J Obstet Gynecol


Utas C, Yalcindag C, Taskapan H, Guven M, Oymak O,

Yuceosy M. Acute renal failure in Central Anatolia. Nephrol

Dial Transplant 2000;15:152–5.

Parkash J, Vohra R, Wani IA, Murthy AS, Srivastva PK,

Tripathi K, et al. Decreasing incidence of renal cortical

necrosis in patients with acute renal failure in developing

countries: a single centre experience of 22 years from Eastern

India. Nephrol Dial Transplant 2007;22(4):1213–7.

J Ayub Med Coll Abbottabad 2009;21(4) 49

Beauregard CD. Obstetrical acute renal failure: A public

health problem in developing countries. Ren Fail


Parkash J, Kumar H, Sinha DK, Kedalaya PG, Pandey LK,

Srivastva PK, et al. Acute renal failure in pregnancy in a

developing country: twenty years of experience. Ren Fail


Chugh KS, Singhal PC, Sharma BK, Pal Y, Mathew MT,

Dhall K, et al. Acute renal failure of obstetric origin. Obstet

and Gynecol 1976;48:642–6.

Ali A, Zaffar S, Mehmood A, Nisar A. Obstetrical acute

renal failure from Frontier Province: A 3 years prospective

study. J Postgrad Med Inst 2004;18(1):109–17.

Naqvi R, Akhter F, Ahmad E, Shaikh R, Ahmad Z, Naqvi A

et al. Acute renal failure of obstetrical origin during 1994 at

one centre. Ren Fail 1996;18(4):681–3.

Ansari MR, Laghari MS, Solangi KB. Acute renal failure in

pregnancy: one year observational study at Liaqat University

Hospital, Hyderabad. J Pak Med Assoc 2008;58(2):61–4.

Selcuk NY, Odabas AR, Cetenkaya R, Tonbol HZ, San A.

Outcome of pregnancies with HELLP syndrome complicated

by acute renal failure (1989–1999). Ren Fail 2000;22:319–27.

Celic C, Gezginc K, Alintepe L, Tonbul HZ, Yaman ST,

Akyurek C, Turk S. Results of the pregnancies with HELLP

syndrome. Ren Fail 2003;25:613–8.

Hachim K, Badahi K, Benghanem M, Fatihi EM, Zahiri K.

Obstetrical acute renal failure. Experience of nephrology

department, Central University Hospital Ibn Rochd,

Casablanca. Nephrologie 2001;22(1):29–31.

Ventura JE, Villa M, Mizraji R, Ferreiros R. Acute renal

failure in pregnancy. Ren Fail 1997;19(2):217–20.

Alexopoulos E, Tambakoudis P, Bili H, Sakellarious G,

Mantalenakis S et al. Ren Fail 1993;15(5):609–13.

Randeree IG, Czarnocki A, Moodley J, Seedat YK, Naiker

IP. Acute renal failure in pregnancy in South Africa. Ren Fail



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