Pregnancy in women on regular hemodialysis

Three cases of pregnancy occurred in our unit in patients who were on hemodialysis before conception. Dialysis frequency was increased, and predialysis BUN was below 100 mg/dl in all three cases. A high-flux dialyzer was used with two patients, and volume-controlled ultrafiltration with bicarbonate bath was used for all three. All of the pregnancies resulted in live births, although prematurity was a problem in two. Erythropoietin use was continued during one pregnancy, eliminating the need for blood transfusion. No problems were encountered with EPO administration, apart from worsening hypertension at the end of pregnancy. One baby developed congenital hydrocephalus, which was not previously reported in pregnancy in hemodialysis patients.