Pregnancy in chronic hemodialysis patients in the Kingdom of Saudi Arabia

Pregnancy rarely occurs in chronic hemodialysis (HD) patients. In an attempt to survey the incidence of pregnancy in our HD population in the Kingdom of Saudi Arabia over the past 5 years, we sent a questionnaire to the 63 centers currently operating in the Kingdom. There were a total of 2,170 patients in the centers, 907 of whom were females. Twenty-one centers, with 50% of all the females on dialysis in Saudi Arabia, responded. Twenty-seven pregnancies in 22 patients were reported. Their ages ranged from 21 to 40 years, with a mean of 26 years. All patients had successful past pregnancies before renal failure. All pregnancies occurred between 1 month to 5 years after beginning HD. Five patients had more than one pregnancy while on HD treatment. Ten pregnancies continued for more than 28 weeks, with seven cases continuing for more than 34 weeks. Eight of the successful pregnancies ended in live births, with one report of ventricular septal defect (VSD). All but two deliveries, which were induced, were spontaneous, with negligible morbidity of mothers and babies. The rest of the pregnancies (total, 17) were unsuccessful despite efforts to continue them and ended before 28 weeks of pregnancy. There were no significant differences in blood pressure, hemoglobin level, serum creatinine, type of dialysate, location of HD centers, past history of gestation, or duration on HD between the subgroups of pregnancies ending before or after 28 weeks. Dialysis hours per week were significantly longer in the patient group with pregnancy continued more than 28 weeks compared with the group with shorter duration of pregnancy.