Case Report
Volume 2 Issue 2 - 2015
Successful Pregnancy and Child Birth of A 43- Year - Old Woman on Five Years Continuous Ambulatory Peritoneal Dialysis (CAPD)
Glavas Boras S1*, Puretic Z Zlopasa G2, Smalcelj R1, Slavicek J1, Barisic I1, Balic R1, Knezevic N3 and Boras S4
1Department of Dialysis, University Hospital Centre Zagreb, Zagreb, Croatia
2Department of Gynecology and Obstetrition, University Hospital Centre Zagreb, Zagreb, Croatia
3Department of Urology, University Hospital Centre Zagreb, Zagreb, Croatia
4Harni Gynecology Polyclinic, Zagreb, Croatia
*Corresponding Author: Glavas Boras S, Department of Dialysis, University Hospital Centre Zagreb, Zagreb, Croatia.
Received: October 29, 2015; Published: November 02, 2015
Citation: Glavas Boras S., et al. “Successful Pregnancy and Child Birth of A 43- Year - Old Woman on Five Years Continuous Ambulatory Peritoneal Dialysis (CAPD)”. EC Gynaecology 2.2 (2015): 185-187.
Successful pregnancies and deliveries of healthy infants by dialyzed patients with chronic renal failure are very rare. We present a case of 43-year-old patient who experienced normal conception after 5 years of CAPD treatment the gestation period, delivery, and one year development of an infant and mother on CAPD.
Case report
A 43-year-old female patient was in the condition of terminal renal insufficiency due to chronic glomerulonephritis included in chronic peritoneal dialysis program (CAPD) 2003. Prior to pregnancy, she maintained diuresis at approximately 600 ml daily and did not have any peritonitis attack. In November 2007, she conceived spontaneously and wished to keep pregnancy. The dose of peritoneal dialysis using the CAPD method was adjusted to gestation periods so that she had 1500 ml CAPD exchange five times daily from the 4th month till the last two weeks, and then 1200 ml till the end of pregnancy. The patient is 160 cm tall and her weight at the onset of pregnancy was 52 kg, 60 kg immediately before childbirth, and 54 kg one week after delivery. Immediately before entering delivery room in her 38th gestation week + 4 days that followed spontaneous amniotic sac rupture, the child-bearing patient drained the CAPD dialysis fluid herself. She gave spontaneous birth to a 45 cm long female infant weighing 2250g. The infant was very vital immediately after birth (APGAR 10/10). Diuresis at 1300 ml daily was stimulated postpartum in the mother, and 1000 ml CAPD five times daily was initiated to the patient on the 2nd day post-birth. The quantity of dialysis solution inflow was gradually increased during one month, with concurrent reduction in exchange rate to 3 times per 2000 ml of dialysis solution daily. Lactation occurred in the patient on the 8th day postpartum. Physical and mental development of the infant during the first year was regular: height: 74 cm, weight: 9500g.
Exchanges from 4 x 2000 ml to 5 x 1200 ml
Ultrafiltration from 500 ml to 1000 ml
Diuresis from 54 kg to 1000 ml
Weight from 54 kg to 61 kg
Glucosae from 4.0 mmol/l to 4.6 mmol/l
Urea from 11.5 mmol/l to 18.7 mmol/l
Creatinine from 541 µmol/l to 713 µmol/l
Positive attitude toward pregnancy and the wish to bear a child in a mentally strong woman supported by her family were crucial during the pregnancy, childbirth and postpartal period of the reported patient. Professional team support was also very important, particularly in managing dialysis in a manner to enable the patient’s recovery for spontaneous pregnancy and delivery of a vital infant. Critical gynecologist’s decision to prepare the patient for spontaneous childbirth allowed CAPD continuation postpartum. Five-year CAPD therapy allowed the patient’s recovery to the extent that she spent her pregnancy, childbirth and postpartal course better than many healthy women in their 43rd year of life.

From left to right:
Glavas Boras S., Nephrologist, CAPD pregnant patient, Zlopasa G., Obstretition.

Copyright: © 2015 Glavas Boras S., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

August Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the August issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before August 18, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.