Endocrine Abstracts

Introduction: Pregnancy in case diabetes complicated by chronic renal failure is characterized by a very high maternal and fetal risk.

Method: We report the case of a patient with diabetes and chronic renal failure at the hemodialysis stage who wishes to lead a pregnancy despite all the risks involved and of which she had been informed beforehand.

Results: This is a 39-year-old patient, with type 1 diabetes for 26 years. Her diabetes is poorly balanced (HbA1C = 8.4%), multi complicated, with lasered diabetic retinopathy, diabetic peripheral neuropathy, and chronic renal failure, on hemodialysis for 8 years. The menarche was at the age of 17 years with irregular cycles. She has an obstetric history of 5 spontaneous abortions. The current pregnancy was not scheduled. The preconceptional body mass index (BMI) was 21.7 kg/m². The blood pressure were correct. She had microcytic hypochromic anemia with hemoglobin at 6.7 g/dl, a urinary tract infection and peripheral hyperthyroidism of incidental discovery whose etiological assessment is in progress. The phosphocalcic balance was correct. The glycemic balance in this patient was difficult especially on the day of hemodialysis.

Conclusion: conception in diabetic hemodialysis patients is exceptional and requires multidisciplinary management to be able to carry it through without maternal and fetal complications represented mainly by fetal loss, malformations linked to chronic hyperglycemia and anemia.