Enfermedad renal crónica en una paciente obstétrica desde la perspectiva teórica de Dorothea Orem

Abstract

The World Health Organization defines chronic kidney disease (CKD) as the gradual loss of kidney function, for a period of time greater than 3 months, determined by a glomerular filtration rate. Currently the global prevalence of pregnant women with CKD is 3%, a relatively low percentage. In obstetric patients with a history of kidney failure, these changes can exacerbate kidney disease and even decompensate, reaching more advanced stages that compromise the life of the mother and the fetus. Presentation of the case: On 07/08/2022, a 27-year-old female patient of ± 24 gestation weeks with a diagnosis: Arterial Hypertension + Severe Preeclampsia + Chronic Kidney Disease who came with reference from the Hemodialysis Center, for presenting ± 6 hours ago. elevated blood pressure 165/105 mmHg and headache that did not improve with analgesia before and after hemodialysis session for which he went to the Teófilo Dávila Hospital. On 08/10/22, after discussing the patient's case among several professionals from different specialties, it was agreed that the pregnancy would continue despite the risks that this implies for both the newborn and the mother, taking into account that daily clinical examinations will be carried out and given the instability of the same, it will be interrupted at any time. On 08/21/22 she was taken to the Obstetric Center to perform a Cesarean Section + Bilateral Salpingectomy and later transferred to the Intensive Care Unit area. On 08/23/22 she was admitted to the Gynecology hospitalization area. On 08/26/22 she was admitted to the Obstetric Center for Hematoma Drainage. On 08/31/22 she was discharged by Nephrology and on 09/02/22 she was finally discharged in stable condition.