Tag Archives: renal

Take-home messages from Maternal Critical Care study day

Pregnant women have lower oncotic pressure so have a lower threshold for pulmonary oedema.

TTP. Do not give platelets. Femoral vascath & plasma exchange.

Placental abruption. Causes DIC so give blood products early and aggressively.

To do regional in bleeding diathesis? If diathesis is corrected then its fine.

Renal disease in pregnancy:

  • In pregnancy normal values are Cr 50/Ur 3.3 (compared to 70/4)
  • Treat the cause
  • Avoid NSAIDs/toxins
  • Keep on dry side (as pul oedema is worse than AKI)
  • Talk to nephrologist
  • Hypertensives do worse than normotensives

Cannot bronchi down a size 7.0 ETT so use a larger size if possible.

Renal Disease in Pregnancy

Chronic Renal Impairment – mild.
Treat as normal

Chronic Renal Impairment – severe
Dialyse on morning
Timing of anticoagulation. Consider plt dysfunction for regional. COnsider difficult airway and aspiration risk for GA
Avoid invasive monitoring (risk of infection) and protect AV fistula
Optimise Hb

Renal transplant
Consider altering surgical incision
Avoid hypotension & hypertension
Optimise Hb
Avoid nephrotoxins