Involvement of clinical engineers in outpatient maintenance dialysis up to 30 weeks of gestation in pregnant dialysis patients who wish to undergo full-term delivery

A pregnant patient in her early 30s was in the early stages of hydronephrosis-induced end-stage renal failure. She already had one child, and her primary physician recommended that she terminate the pregnancy, but she strongly desired its continuation. The obstetrics and gynecology department concluded that the pregnancy could continue. In the 10th gestational week, the patient’s renal replacement therapy was changed from hemodialysis for 4 hours 3 times a week to predilution online hemodiafiltration (oHDF) for 4 hours 3 times a week. In the 12th week of pregnancy, the treatment was switched to oHDF for 4.5 hours 5 times a week. A clinical engineer fine-tuned the daily dialysis conditions, and the patient’s pregnancy was managed according to our clinic’s standards. No polyhydramnios or other abnormalities were seen during the course of the patient’s pregnancy. She was admitted at 30 weeks, and underwent a caesarean section in the 37th gestational week. We report that women with end-stage renal failure can successfully deliver babies without complications and describe the role of clinical engineering in such cases.