Post-partum acute renal failure: A case report

IF 0.7 Q4 OBSTETRICS & GYNECOLOGY

Current Obstetrics and Gynecology Reports Pub Date : 2021-01-01 DOI:10.15761/ogr.1000153

Diana Padovani, M. Angelini, L. Driul

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Abstract

Background: Acute renal failure associated to renal cortical necrosis is a rare condition that can appear in pregnancy, during or after the delivery. It can be caused by various factors which must all be excluded in order to reach the correct diagnosis. Due to its low incidence in developed country, it presents a challenging diagnosis, cause management and treatment. Case report: Here we report a rare case of acute renal failure with renal cortical necrosis probably caused by post-partum hemorrhage. A 36-years-old primiparous woman, after a post-partum hemorrhage, presented low platelets count, anuria and increase serum creatinine level that necessitate daily dialysis and Continuous Veno-Venous Hemofiltration. After the discharge she presented persisting stage IV chronic renal insufficiency, currently being treated. After excluding all possible causes of pregnancy-related acute renal failure, the only reasonable explanation was renal cortical necrosis due to post-partum hemorrhage. Conclusion: Due to a loss of 3000 cc of blood, the patient suffered of a life threating disease. The acute renal failure is a serious condition that must be taken into consideration in case of post-partum bleeding and promptly.

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产后急性肾功能衰竭1例

背景:急性肾功能衰竭合并肾皮质坏死是一种罕见的情况，可出现在怀孕期间，期间或分娩后。它可以由各种因素引起，必须全部排除，以达到正确的诊断。由于在发达国家发病率较低，该病的诊断、病因管理和治疗都具有挑战性。病例报告:我们报告一例罕见的急性肾功能衰竭合并肾皮质坏死，可能是由产后出血引起的。一位36岁的初产妇，在产后出血后出现血小板计数低、无尿和血清肌酐水平升高，需要每日透析和持续静脉-静脉血液滤过。出院后出现持续IV期慢性肾功能不全，目前正在治疗中。排除所有可能的妊娠相关性急性肾功能衰竭原因后，唯一合理的解释是产后出血所致肾皮质坏死。结论:由于失血3000毫升，病人患上了一种危及生命的疾病。急性肾功能衰竭是一种严重的疾病，在产后出血的情况下必须予以考虑并及时治疗。

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Current Obstetrics and Gynecology Reports OBSTETRICS & GYNECOLOGY-

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期刊介绍： This journal aims to provide expert review articles on significant recent developments in obstetrics and gynecology. Presented in clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the diagnosis, treatment, management, and prevention of conditions that compromise the health of women. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endometriosis, infertility, menopause, prenatal medicine, and vulval and cervical lesions. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of nearly 20 international members reviews the annual table of contents, suggests articles of special importance to their country/region, and ensures that topics include emerging research. Commentaries from well-known figures in the field are also provided.