Haemostatic Dysfunction in Pregnancy Related Renal Disease

Abstract

Introduction:  Acute renal failure in pregnancy is a challenging clinical condition and coagulation disturbance add to dis-tressing condition of patient. The present study was carried to determine status of haemostasis in these patients. In this study 40 pregnant females who presented with acute renal failure were taken.

Study Design:  It was a descriptive and case-series study.

Material and Methods:  Forty pregnant females were included in the study. The demographic information Name, Age, Sex and address was noted. The history of present illness was obtained and they were examined for positive signs. Routine laboratory investigations CBC (Haemoglobin, TLC, DLC and platelet count) were carried out on sysmex KX21 and verified by peripheral smear examination. Serum urea and creatinine levels were obtained to establish ARF and see the degree of renal insult. Prothrombin time, Activated partial thromboplastin time and Fibrinogen levels were carried out to establish coagulopathy. These tests were performed by the standard manual method which is also the gold standard.

Results:  In our study gastroenteritis (22%) and Ante partum haemorrhage (15%) were among the leading causes of pregnancy related renal failure. Prothrombin time was significantly raised in 42%, Activated Partial Thromboplastine Time in 45% and raised fibrinogen in 20% of cases.

Discussion:  Pregnancy related acute renal failure is a disappearing entity in west but in our set up it is still a significant cause of antenatal morbidity. Many studies especially in the developing countries matched our results.

Conclusion:  Disturbed haemostasis in pregnancy related acute renal failure is a significant condition and patients should be closely monitored to prevent morbidity and mortality.

Key Words:  Coagulation, Pregnancy, Acute Renal Failure, Prothrombin time.