Pregnancy and postpartum experiences of women undergoing hemodialysis: a qualitative study

Abstract

Introduction: There are particularities of chronic kidney disease (CKD) in women and their treatment. The biology of women exposes them to greater risk factors for CKD and both pregnancy and the postpartum period place an additional burden on renal health. Pregnancy complications may cause or worsen CKD. Objective: To explore the experiences of women with CKD undergoing hemodialysis in relation to their reproductive history. Methods: This study consisted of clinical-qualitative design with semi-structured individual interviews and open-ended questions. The sample selection was intentional and according to the theoretical saturation criterion. The data analysis was carried out based on the seven steps of the clinical-qualitative content analysis and validated by Nvivo11. This study was conducted in a public hemodialysis clinic of the Brazilian National Health System. Results: Twelve women undergoing hemodialysis were interviewed. The results from the analysis revealed three categories: 1) Association of pregnancy with CKD; 2) Nebulosity in relation to diagnosis and reproductive history 3) Being a woman undergoing hemodialysis. Conclusion: Our study showed the importance of considering the specificities of CKD in women, suggesting that these issues are important for diagnosis and treatment adherence. Consideration of reproductive life history allows the health of women undergoing hemodialysis to be promoted holistically, including aspects of mental health.

Gestational hypertension as a factor associated with chronic kidney disease: the importance of obstetric history of women undergoing hemodialysis

“…Therefore, some information may have been forgotten or confounded, and there were some missing data, particularly regarding renal disease status. In addition, the lack of knowledge of hemodialysis patients about their disease is an issue that needs to be valued and addressed by the health teams that treat these patients 17 . In women with more than one pregnancy, the pregnancy index of adverse outcomes was not identified because of the limitation of the method.…”

Hipertensão gestacional como fator associado à doença renal crônica: a importância do histórico obstétrico de mulheres submetidas à hemodiálise

“…Portanto, algumas informações podem ter sido esquecidas ou confundidas, e houve alguns dados ausentes, particularmente no que diz respeito ao status da doença renal. Além disso, a falta de conhecimento dos pacientes em hemodiálise sobre sua doença é uma questão que precisa ser valorizada e abordada pelas equipes de saúde que cuidam desses pacientes 17 . Em mulheres com mais de uma gravidez, o índice de gestação de desfechos adversos não foi identificado, devido à limitação do método.…”

Direitos reprodutivos para as mulheres com doença renal crônica. Infelizmente, ainda estamos engatinhandos

“…No entanto, apesar de uma postura mais paternalista dos médicos, desaconselhando e mesmo proibindo a gestação, muitas pacientes engravidaram. O trabalho de Schützer e colaboradores com desenho clínico qualitativo ajuda a entender a dinâmica das inter-relações complexas entre DRC e gestação sob o ponto de vista dessas mulheres 2 . Apesar de a experiência de ter DRC e estar grávida ser muito individual, os trabalhos qualitativos conseguem promover uma visão mais holística desses relatos e auxiliar nos cuidados dessas pacientes.…”