A normal pregnancy is associated with major changes in the structure and function of the kidneys. There are many disorders that can lead to kidney problems during pregnancy, challenging the outcomes for the mother and child.
We commonly come across two kinds of situations wherein, pregnancy and kidney disease confront each other at crossroads.
One may have an undetected kidney disease which may come to attention during routine antenatal visits. This may manifest as a rise in blood pressure or detection of protein in the urine. Such patients require careful monitoring of their blood pressures to detect the onset of a life-threatening complication – “Eclampsia”; which is more common in patients with underlying kidney problems.
On the other end of the clinical spectrum, kidney disease may complicate an otherwise normal pregnancy. The reasons are many and they vary according to the time of gestation. For example, in the first trimester, many women may have excessive vomiting – a condition known as Hyperemesis gravidarum. Severe dehydration may ensue, which may lead to kidney dysfunction. It is easily correctable with hydration.
There are other kidney problems that might occur later during the pregnancy like Thrombotic microangiopathy – which is characterized by the breakdown of blood components and multi-organ failure. It is a life-threatening complication and treatment involves special interventions like plasma exchanges with or without renal replacement therapy.
Beyond mid-term, certain diseases like Pre-eclampsia are increasingly recognized. Women may experience swelling in their legs, fluctuating blood pressure which is difficult to control. Often urine tests may reveal leakage of protein. Unrecognized, it may go on to involve multiple organs leading to kidney and liver failure and the development of convulsions – a condition known as Eclampsia or toxemia of pregnancy. Definitive treatment of this life-threatening complication requires emergent delivery of the baby, after which the mother gradually starts improving within the next 48-72 hours.
Here’s how you can take care of your kidneys during pregnancy:
- Regular ante-natal check-ups
- Control blood pressure
- Protein in urine and high BP may be the early harbingers of underlying kidney problems. Seek the help of a specialist.
Timely recognition of any complication is crucial. With appropriate treatment, it is possible to manage pregnancy well, ensuring a healthy mother and baby.