Figure 1018

Because fertility is decreased in end-stage renal disease, pregnancy is uncommon in women on chronic dialysis. When pregnancies occur, however, only about 20% to 30% are successful, with the chances of success increasing when residual renal function exists [20]. The overall strategy should be to maintain blood chemistry levels as close as possible to normal by increasing the number of hours of dialysis to 20 or more. Erythropoietin may be used in pregnancy. Blood pressure control is important, and low doses of heparin should be used to prevent bleeding. There are no apparent advantages of chronic ambulatory peritoneal dialysis compared with hemodialysis. The incidence of worsening maternal hypertension and subsequent premature delivery is high.

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