Acute renal failure in pregnancy: a review of clinical outcomes at an inner-city hospital from 1986-1996.

Acute renal failure is a serious complication of pregnancy. Over the past few decades, the overall incidence of acute renal failure in pregnancy has decreased in Western societies. In less developed countries, the incidence of acute renal failure in pregnancy has remained high. This retrospective study examined the incidence, morbidity, fetomaternal mortality, and renal prognosis among pregnant inner-city patients. Serum creatinine levels of all pregnant patients seen at an inner-city hospital from January 1986 to December 1996 were reviewed. Twenty-one consecutive cases of acute renal failure were identified for an incidence of 2 in 10,000 pregnancies. Maternal mortality was high (15.7%) as was morbidity, with a tendency toward a high rate of intrauterine fetal growth retardation. These results suggest that the outlook for acute renal failure in inner-city patients is dismal in sharp contrast to the prognosis for other patient groups with acute renal failure in pregnancy in Western societies. Preventive strategies should be aimed at this subpopulation with a view to improving early prenatal care as well as enhancing overall access to the health-care system.