Abstract:
The examination of 45 patients with acute renal failure (ARF) caused by obstetric problems identified 3 types of its clinical course: 1) "pure" ARF; 2) ARF in the presence of sepsis, and 3) ARF in the presence of exogenous intoxication. Types 2 and 3 were more severe and showed higher mortality rates. The average number of hemodialysis sessions per patient was 2.4, 3.6, and 9.8 with types 1, 2, and 3, respectively. The treatment was of multimodality, including suppurative focus debridement, therapeutic measures, hemodialysis, and hyperbaric oxygenation; with types 2 and 3 efforts were made to combat sepsis, hemodynamic and coagulative abnormalities, multiorgan failure. The operative risk during evolved ARF is extremely high; uterine curettage, rational bacterial therapy, refusal of nephrotoxic agents are preferred. Better treatment outcomes were due to a session of 5-10 hyperbaric oxygenation procedures which were performed in anaerobic sepsis, pulmonary edema, arterial hypoxemia. The patients who had received hyperbaric oxygenation had less severe ARF, lower incidence of complications and lower mortality rates, they tolerated hemodialysis better.
Dubrov, Mazin, Martynov, , , , , , (1991). [The characteristics of the clinical picture and treatment of patients with acute kidney failure in obstetrical pathology]. Akusherstvo i ginekologiia, 1991 Feb;(2):46-50. https://www.ncbi.nlm.nih.gov/pubmed/1862853