Volume 11, Issue 2 (2026)
SJMR 2026, 11(2): 67-72 |
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Karamnia Far M, Sanaye Naderi M, Mohammadian H. Pregnancy in the Setting of Advanced Chronic Kidney Disease Complicated by Early-Onset Severe Preeclampsia, Severe Fetal Growth Restriction, and Placental Abruption: A Case Report. SJMR 2026; 11 (2) : 3
URL: http://saremjrm.com/article-1-396-en.html
URL: http://saremjrm.com/article-1-396-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
3- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
3- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (15 Views)
Introduction: Chronic kidney disease (CKD) is one of the major chronic conditions affecting women of reproductive age and renders pregnancy a high-risk condition. Pregnancy in women with CKD is associated with an increased risk of maternal and fetal complications, including preeclampsia, fetal growth restriction (FGR), preterm delivery, placental abruption, and deterioration of renal function. The management of these patients requires comprehensive preconception assessment, specialized antenatal care, and a multidisciplinary team approach. Herein, we report a case of pregnancy complicated by advanced chronic kidney disease and severe obstetric complications.
Case Presentation: A 36-year-old primigravida (G1P1) with a history of advanced chronic kidney disease was admitted at 26 weeks of gestation because of elevated blood pressure. Clinical and paraclinical evaluations led to the diagnosis of severe preeclampsia, severe fetal growth restriction, abnormal umbilical artery Doppler findings, and placental abruption. Owing to the critical maternal and fetal conditions, supportive management, including administration of betamethasone, magnesium sulfate, and antihypertensive medications, was initiated. Subsequently, the patient underwent an emergency cesarean section with concurrent myomectomy. A preterm female neonate weighing 630 g was delivered and admitted to the neonatal intensive care unit (NICU) because of respiratory distress syndrome and patent ductus arteriosus.
Conclusion: Pregnancy in women with advanced chronic kidney disease is associated with a markedly increased risk of life-threatening maternal and fetal complications. This case highlights the importance of preconception counseling, comprehensive assessment of renal function, close surveillance throughout pregnancy, and multidisciplinary management to facilitate the early recognition of complications and determine the optimal timing of pregnancy termination. Furthermore, this report demonstrates that timely clinical decision-making and prompt intervention may play a pivotal role in reducing maternal complications and improving neonatal outcomes.
Case Presentation: A 36-year-old primigravida (G1P1) with a history of advanced chronic kidney disease was admitted at 26 weeks of gestation because of elevated blood pressure. Clinical and paraclinical evaluations led to the diagnosis of severe preeclampsia, severe fetal growth restriction, abnormal umbilical artery Doppler findings, and placental abruption. Owing to the critical maternal and fetal conditions, supportive management, including administration of betamethasone, magnesium sulfate, and antihypertensive medications, was initiated. Subsequently, the patient underwent an emergency cesarean section with concurrent myomectomy. A preterm female neonate weighing 630 g was delivered and admitted to the neonatal intensive care unit (NICU) because of respiratory distress syndrome and patent ductus arteriosus.
Conclusion: Pregnancy in women with advanced chronic kidney disease is associated with a markedly increased risk of life-threatening maternal and fetal complications. This case highlights the importance of preconception counseling, comprehensive assessment of renal function, close surveillance throughout pregnancy, and multidisciplinary management to facilitate the early recognition of complications and determine the optimal timing of pregnancy termination. Furthermore, this report demonstrates that timely clinical decision-making and prompt intervention may play a pivotal role in reducing maternal complications and improving neonatal outcomes.
Article number: 3
Keywords: Chronic kidney disease, Pregnancy, Preeclampsia, Fetal growth restriction, Placental abruption, Preterm delivery, Case report.
Article Type: Case Report |
Subject:
Pregnancy Care
Received: 2026/06/28 | Accepted: 2026/07/18 | Published: 2026/07/30
Received: 2026/06/28 | Accepted: 2026/07/18 | Published: 2026/07/30
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