• Naushaba Rizwan
  • Syed Farhan Uddin


Background: Acute renal failure (ARF) is a syndrome characterised by rapid decline in glomerularfiltration rate and retention of nitrogenous waste products such as urea and creatinine. The objective ofthis study was to study the prevalence, risk and outcome of women with obstetrical renal failure.Methods: This observational study was conducted in Department of Obstetrics and Gynaecology,Liaquat University Hospital, Hyderabad, Pakistan from October 2009 to September 2010. Thirty-fivepatients with obstetrical acute renal failure were included in the study, patients with chronic renaldiseases, hypertension, diabetes mellitus and renal stones were excluded from the study. A detailedhistory was followed by thorough examination and investigation. Their clinical history, physicalexamination and intake/urine output was recorded. Routine laboratory investigations were done relatedto each case and specialised investigations like renal scan, renal ultrasonography and renal biopsieswere performed in selected cases where recovery was delayed for more than 3 weeks. Results: Totalnumbers of admissions in obstetric ward were 3,285. Pregnancy related acute renal failure was found in35 (1.065%) women. Age ranged from 18–40 years. Most of the women belonged to age group 30–35.Out of 35 women 31.42% had postpartum haemorrhage. Ante partum haemorrhage was found in25.71%, Eclampsia in 17.14%, DIC in 14.28%, and sepsis in 11.42%. Anuria was observed in 25patients, remaining presented with oliguria (28.57%). Haemodialysis was done in 75% of patients,others were managed conservatively. Complete recovery was observed in 53% cases. Maternalmortality was 25.71% and foetal mortality was 22.85%. Conclusion: Pregnancy related ARF is one ofthe most common causes of ARF, it is a dangerous complication of pregnancy which carries very highmortality and morbidity.Keywords: acute renal failure, prevalence, outcome, complications, maternal, foetal, obstetrical


Khalil MA, Azhar A, Anwar N, Aminullah, Najm-ud-Din, Wali

R. Aetiology, Maternal and Foetal Outcome in 60 Cases of

Obstetrical Acute Renal Failure. J Ayub Med Coll Abbottabad


Segheb MM, Ghotbi SH, Moini M. Peripartum Acute Renal

Failure. Shiraz E-Med J 2008;9(1):45–54.

Thadhani R, Pascual M, Bonventre J. Acute renal failure. N Engl

J Med 1996;334:1448–60.

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

pregnancy: One year observational study at Liaquat University

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

Pertuist N, Grunfeld JP. Acute renal failure in pregnancy.

Baillicres Clin Obstet Gynaecol 1994;8:333–51.

Schrier RW. Diseases of Kidney & Urinary Tract. Philadelphia:

Lippincott Williams & Wilkins; 2001.

Parkash J, Tripathi K, Pandey LK, Gadela SR, Usha. Rent

cortical necrosis in pregnancy-related acute renal failure. J Indian

Med Assoc 1996;94:227–9.

Ramzan M. Sameeh JK, Ghiauddin. One year renal outcome of

pregnancy related kidney failure. J Pak Inst Med Sci


Ali A, Zafar S, Mehmood A, Nisar A. Obstetrical acute renal

failure from Frontier Province: A 3 years prospective study. J

Postgrad Med Inst 2004;18:575–84.

Linheimer MD, Katz AI: Renal physiology and disease in

pregnancy. In Seldin DW, Giebisch G (eds): The Kidney:

Physiology and Pathophysiology, 3rd ed. Philadelphia, Lippincott

Williams and Wilkins, 2000.p. 2597.

Chugh KS, Singhal PC, Sharmia BK, Pal Y, Mathew MT, Dhall

K, et al. acute renal failure of obstetric origin. Obstet Gynaecol


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

Yuceosy M. Acute renal failure in central Anatolia. Nephrol Dail

Transplant 2000;15:152–5.

Naqvi R, Akhtar F, Ahmed E, Shaikh R, Ahmed Z, Naqvi A et

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

centre. Ren Fail 1996;18:681–3.

Selçuk NY, Odabas AR, Cetinkaya R, Tonbul HZ, San A.

Outcome of pregnancies with HELLP syndrome complicated by

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

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

syndrome. Ren Fail 2003;25:613–8.

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

in pregnancy. Ren Fail 1997;19:217–20.

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

Ramdani B, et al. Obstetrical acute renal failure. Experience of

Nephrology Department, Central University Hospital Ibn Rochd,

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

Randeree IG, Gzarnocki A, Moodley J, Seedat YK, Naiker IP.

Acute renal failure in pregnancy in South Africa. Ren Fail


Costa De Beauregard MA. Obstetrical acute renal failure: a

public health problem in developing countries.

Nephrologie. 2001;22(1):3-4.

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