An Evaluation of The Clinical And Etiological Profile of Acute Renal Failure in Obstetric Patients: An Observational CrossSectional Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 4
Abstract
Objective: To evaluate the clinical and etiological profile of acute renal failure (ARF) in obstetric patients in Bundelkhand region. Methods: This was observational cross-sectional study. The women with previously healthy kidneys who developed renal complications during their pregnancy due to obstetrical causes were included in the study. A detailed clinical and etiological examination was done and recorded. The criteria for diagnosis of ARF was: urine output output<400 ml/day, history<3 month, bilateral normal sized kidney (9-12 cm) on ultrasonographic examination and abrupt rise of blood urea and serum creatinine. Results: More than one third of patients were between 26-30 years (36%). Multigravida (72%) parity was observed in majority of patients. Fever (70%) was the most common clinical symptom in ARF patients followed by uterine bleeding (60%), hypotension (22%), hypertension (18%), Oliguric/anuric ARF (16%). However, altered sensorium was seen in 14% and jaundice in 12%. Fluid overload and Diarrhoea each was in 10% ARF patients. The percentage of other clinical symptoms was less than 10%. HELLP syndrome (32%) was found to be the most common etiological factor in ARF patients followed by Falciparum malaria (30%), sepsis (26%), disseminated intravascular coagulation (18%), pregnancy induced hypertension (16%) and antepartum haemorrhage (14%). The percentage of other etiological factors was less than 10%. Conclusion: Prevention is the best and least expensive solution to prevent ARF. Preventing sepsis, a good antenatal care and a better management of obstetrical complications are the crucial tools to implement to achieve the purpose.
Authors and Affiliations
Dr. Pankaj Singh, Dr. N. S. Sengar, Dr. Sanjaya Sharma, Dr. Medhavi Gautam
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