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논문분류	춘계학술대회 초록집
제목	The First Successful Pregnancy in a Hemodialysis Patient in Mongolia
저자	Amarjargal Eldev-Ochir
출판정보	2026; 2026(1):
키워드	Keywords: pregnancy, hemodialysis, IgA nephropathy, HELLP syndrome
초록	Case Study: Introduction: Fertility is reduced in patients receiving dialysis; however, pregnancy can still occur despite menstrual irregularities. Data from Australia and New Zealand report 17.8 pregnancies per 1,000 women of reproductive age on dialysis, with a 73% live birth rate. Hypertension, preeclampsia, and HELLP syndrome were observed in 7.7%, 11.9%, and 0.7% of cases, respectively. Longer dialysis duration is associated with improved live birth rates. This report presents the first successful pregnancy in a patient undergoing maintenance hemodialysis in Mongolia. Case Presentation: A 24-year-old woman with chronic glomerulonephritis (diagnosed 2007) was later confirmed to have IgA nephropathy by biopsy in 2013. Progressive renal failure led to initiation of hemodialysis in December 2021. After a prior early medical abortion in 2021, she conceived again in March 2022 while on dialysis. Antenatal care began at 9–10 weeks’ gestation. From week 12, dialysis was intensified to 16–20 hours weekly. Interdialytic weight gain was maintained below 2 kg. Multidisciplinary management included anticoagulation adjustment, strict blood pressure control, anemia management (two units packed red blood cells at 17–18 weeks), infection prevention, and close fetal monitoring. At 28 weeks, she developed COVID-19 infection without complications. At 37–38 weeks (33–34 weeks by ultrasound due to fetal growth restriction), she delivered vaginally. The female neonate weighed 2600 g (length 46 cm). Chromosomal analysis was normal. Hirschsprung’s disease was diagnosed on day 12 of life and surgically corrected in stages. At 3 years of age, the child shows normal physical and neurodevelopmental outcomes. Conclusion: Although pregnancy in hemodialysis patients is high-risk, favorable maternal and neonatal outcomes are achievable with intensified dialysis, strict volume and blood pressure control, anemia management, and coordinated multidisciplinary care. Careful contraception counseling and individualized dialysis adjustment remain essential.
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