Acute Renal Failure in Obstetric Patients: Analysis of Risk Factors & Fetomaternal Outcome

Objective: To investigate the risk factors and feto-maternal outcomes associated with acute renal failure (ARF) among obstetric patients at Liaquat University Hospital, Hyderabad. Methodology: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Liaquat University Hospital, Hyderabad, from November 2021 to April 2022. Pregnant women aged 20–40 years, diagnosed with ARF, were included. Risk factors, maternal outcomes (complete recovery, partial recovery, or dialysis requirement), and fetal outcomes (stillbirth or neonatal death) were recorded via a structured proforma. Data were analyzed using Microsoft Excel 2016 and SPSS version 26.0. Results: A total of 73 patients were studied, with a mean age of 28.61 ± 5.78 years. Postpartum hemorrhage was observed in 16.4% of cases, followed by antepartum hemorrhage in 28.8%, disseminated intravascular coagulation (DIC) in 5.5%, HELLP syndrome in 5.5%, puerperal sepsis in 5.5%, and pre-eclampsia in 15.1% of cases. Additionally, 17.8% of women experienced abortion, while mismatched blood transfusions occurred in only 2.7% of cases. Regarding maternal outcomes, 2.7% of women fully recovered, 34.2% showed partial recovery, and 63.0% required dialysis. In terms of fetal outcomes, neonatal death was reported in 37.1% of cases, stillbirth occurred in 15.0% and 47.9% of newborns survived. Pregnancy outcomes were statistically insignificant concerning age, parity, socioeconomic status, residential status, and booking status (p ≥ 0.05) Conclusion: Antepartum hemorrhage, postpartum hemorrhage, DIC, HELLP syndrome, puerperal sepsis, and pre-eclampsia were identified as major risk factors for ARF in pregnancy. ARF was associated with poor feto-maternal outcomes, particularly increased fetal mortality.