Twin pregnancy in a patient on chronic haemodialysis who already had three pregnancies

  • Pascaline M. AlixEmail author
  • Flora Brunner
  • Anne Jolivot
  • Muriel Doret
  • Laurent Juillard
Case Report
Part of the following topical collections:
  1. Obstetric Nephrology


Pregnancy in women with end-stage renal disease is rare. Multiple pregnancies carry a high risk of complications even in healthy individuals. We report the case of a 36-year-old woman who had four pregnancies while she was on dialysis, including one twin pregnancy. The last pregnancy occurred while in the 14th year of hemodialysis. At 8 weeks of gestation (WG), ultrasonography diagnosed a dichorionic diamniotic twin pregnancy. The frequency of dialysis was increased from 3 to 6 times a week and each session lasted 4 h. At 22 WG, polyhydramnios was diagnosed. At 25 WG, the patient presented respiratory distress and was transferred to intensive care where continuous hemodialysis, non-invasive ventilation, antibiotic and tocolysis were initiated. Because of tocolysis failure, a cesarean section was performed and she delivered male twins. The two newborns weighed 790 and 870 g, respectively. To our knowledge, this is the first report of four pregnancies in hemodialysis including one twin pregnancy. The incidence of pregnancy and a better outcome in patients on hemodialysis has increased in recent years but a tight coordination between nephrologists and obstetricians is essential.


Twin pregnancy Four pregnancies Chronic hemodialysis Daily hemodialysis 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  • Pascaline M. Alix
    • 1
    Email author
  • Flora Brunner
    • 1
  • Anne Jolivot
    • 1
  • Muriel Doret
    • 2
  • Laurent Juillard
    • 1
  1. 1.Department of Nephrology, Dialysis and Hypertension, Edouard Herriot HospitalHospices Civils de LyonLyonFrance
  2. 2.Department of Obstetrics and Gynaecology, Hôpital Femme-Mère-EnfantHospices Civils de LyonLyonFrance

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