OBSERVATIONAL STUDY TO FIND OUT AND DECIDE ABOUT PREGNANCY ASSOCIATED ARF THROUGH CALCULATING CONCLUSION AND ETIOLOGY

Objective: The purpose of this study was to find out and decide about pregnancy associated acute renal failure through calculating conclusion, etiology and to conclude the occurrence of it. Study Design: Hospital base prospective and observational research study. Place and Duration: Present research was carried out in the time duration of 12 months from April 2017 to March, 2018 at the department of nephrology, Mayo Hospital Lahore. Methodology: Including 19% (40) women with ARF (Acute Renal Failure) 56% (118) women and 44% (92) men making a total number 210 having ARF (Acute Renal Failure) selected for the current study. Out of 40 pregnancy cases 16 were from urban areas and 24 were from rural areas of Punjab, Pakistan. Used a pre-formulated proforma for collection of data. Carried out physical examination and collected medical history information of all patients. Carried out all related laboratory tests and in some cases performed renal biopsy. Recorded the final results derived from observations and comparisons. Results: 40 women with pregnancy found affected by ARF out of which 45% (18) patients were primigravida and multipara were 55% (22) with mean age as 29 ± 4.50 years. 20% (08) patients got adequate antenatal care and remaining 80% (32) patients did not received any antenatal treatment. Found ARF (Acute Renal Failure) in 15% (12) patients during 1st and 2nd trimester of pregnancy whereas, during puerperium or 3rd trimester 70% (28) cases developed acute renal failure. Patients of anuria were 60% (24). Found HELLPS in 5% (02), IUD (Intrauterine Fetal Death) in 30% (12), DIC in 10% (04), puerperal sepsis in 20% (8), Septic abortion in 15% (06), PPH (Post-Partum Hemorrhage) in 15% (06) and APH (Antepartum Hemorrhage) in 05% (02) cases. The most common cause of ARF was sepsis. 15% (06) patients didn’t required any dialysis whereas, 85% (34) patients got hemodialysis. Acute Tubular Necrosis (ATN) was the most common medical diagnosis. 20% (08) patients showed 100% recovery. Patchy cortical necrosis was there in 45% (18) patients and observed acute renal cortical necrosis in 35% (14) patients. Recorded 30% overall death ratio. Conclusion: Average of infection and death was high in pregnancy related acute renal failure. Particularly in the villages of Punjab, Pakistan, it is a major healthiness problem. Acute Tubular Necrosis (ATN) was a leading cause with reversible ARF, whereas, the reason of permanent loss of kidney functions was cortical necrosis. Lack of prompt management, lack of poor healthcare facilities and fewer numbers of antenatal health care centres are the main diagnosed issues of possibly reversible ARF (Acute Renal Failure). Key Words: Pregnancy, Patients, ARF (Acute Renal Failure)