Abstract
Background: Pregnancy-related acute kidney injury (PRAKI) contributes to 3–7% of overall acute kidney injury (AKI) cases in Indian subcontinent. It reflects the absence of prenatal care and early detection of high-risk pregnancies, the delay in transfer of patients and the paucity of relevant human and material resources. It is certainly a treatable and curable complication, but one that imposes a heavy burden of maternal morbidity and mortality if its diagnosis and treatment are delayed. The best treatment remains prevention, a goal very difficult to attain in the developing countries.Materials and methods: AKI was diagnosed when there was a history of sudden oliguria (urinary output < 400 ml over 24 hrs or less than 20ml/hour) or anuria with a sudden increase in serum creatinine to more than 1.5mg/dl or an increase in serum creatinine of > 0.5mg/dl/day from baseline. All patients with obstetrical AKI, antepartum as well as postpartum, were included in this study. Results: Out of 40 patients detected, the mean gestational age of the patients at the time of admission was 32 + 1.2. 62.5% of the subjects were detected in the third trimester.75% of the subjects were Multigravida and 25% were primigravida. Around 80% of the study subjects developed ARF in the antenatal period and 20% in the postpartum period.57.5% of the AKI patients had hypertensive disorder of pregnancy, followed by APH (20%),PPH (17.5%),Septic abortion (5%).Maternal outcome is graded was as per KDIGO grading, maximum no. of patients (75%) fall in grade 1, followed by grade 2 (20%), grade 3 (5%).There was complete recovery in 23 patients , and death was 1 in our study. There were 21 preterm births, Live births > 2.5 kg were 14, there were 3 IUFD. Total NICU admissions were 24.In most of the cases, termination of pregnancy was done after stabilizing the patient owing to obstetric emergency Conclusions: Multidisciplinary services at tertiary level may reduce mortality due to Pregnancy related Acute Renal Failure. Most common etiological factor was pre eclampsia and eclampsia. Disappearance of illegal abortion, improvement in ANC with effective management of complicated pregnancy, the facility for safe early elective delivery whenever indicated, the improvement in resuscitation of obstetric hemorrhage and increased preparation of hospital birth had all contributed to the prevention of this devastating complication of pregnancy.