Often, pregnancy does not cause a kidney disorder to worsen. Usually, kidney disorders worsen only in pregnant women who have high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more that is not well-controlled. If pregnant women have a kidney disorder, they are more likely to develop high blood pressure, including preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more (a type of high blood pressure that develops during pregnancy).
Having a chronic kidney disorder before becoming pregnant increases the risk that the fetus will not grow as much as expected (small for gestational age Small-for-Gestational-Age (SGA) Newborn A newborn who weighs less than 90% of newborns of the same gestational age at birth (below the 10th percentile) is considered small for gestational age. Newborns may be small because their parents... read more ) or be stillborn Stillbirth Stillbirth is death of a fetus after 20 weeks of pregnancy. Pregnancy complications are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur... read more . Having a severe kidney disorder usually prevents women from carrying a baby to term.
In pregnant women who have a kidney disorder, kidney function and blood pressure are monitored closely, as is growth of the fetus. If the kidney disorder is severe, women may need to be hospitalized after 28 weeks of pregnancy so that bed rest is guaranteed, blood pressure can be controlled well, and the fetus can be monitored closely.
Women who have had a kidney transplant Kidney Transplantation Kidney transplantation is the removal of a healthy kidney from a living or recently deceased person and then its transfer into a person with end-stage kidney failure. (See also Overview of Transplantation... read more are usually able to safely give birth to healthy babies if they have all of the following:
A transplant that has been in place for 2 or more years
Normal kidney function
No episodes of rejection
Normal blood pressure
Women who have a kidney disorder that regularly requires hemodialysis Hemodialysis Dialysis is an artificial process for removing waste products and excess fluids from the body, a process that is needed when the kidneys are not functioning properly. There are a number of reasons... read more are often at high risk of pregnancy complications, including miscarriage Miscarriage A miscarriage is the loss of a fetus due to natural causes before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect)... read more , stillbirth Stillbirth Stillbirth is death of a fetus after 20 weeks of pregnancy. Pregnancy complications are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur... read more , preterm birth Preterm Labor Labor that occurs before 37 weeks of pregnancy is considered preterm. Babies born prematurely can have serious health problems. The diagnosis of preterm labor is usually obvious. Measures such... read more , and preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more . But because of advances in dialysis treatment, up to 90% of babies born to these women survive.
Usually, delivery is required before the due date because the woman develops preeclampsia or the fetus is not growing as much as expected. Doctors may remove and analyze a sample of the fluid that surrounds the fetus (amniotic fluid). This procedure, called amniocentesis Amniocentesis Prenatal diagnostic testing involves testing the fetus before birth (prenatally) to determine whether the fetus has certain abnormalities, including certain hereditary or spontaneous genetic... read more , helps doctors determine whether the fetus’s lungs are mature enough to breathe air and thus when the baby can be delivered safely.
Cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more is often done, but sometimes vaginal delivery is possible.