[Pregnancy and labor in females with solitary kidney].

Aim: To propose optimal policy of pregnancy and labor management in females with solitary kidney.
Material and Methods: The study included 102 pregnant women who had contracted or transplanted donor kidney, renal aplasia (17, 3 and 28 females, respectively) or had undergone nephrectomy for different diseases (n = 54). Filtration, concentration, nitrogen-eliminating renal functions, renal hemodynamics, bacteriological picture of the urine were examined. Also, ultrasonography of the kidneys, cardiotocographic monitoring, ultrasonic fetal biometry, dopplerometry of placental blood flow were made.
Results: Most of the pregnant women showed declined function of the solitary kidney, but renal insufficiency was a rare finding. Pyelonephritis of the solitary kidney, on the contrary, occurred rather frequently (77.8%) causing intrauterine infection in 46% of the fetuses. Obstetric complications arose more frequently than in women with two kidneys: gestosis--28%, threatened abortion--18%, premature delivery--25%. Hypotrophy was registered in 23% of the newborns. Adequate management of pregnancy reduced stillbirth rate to only 5%. 78% of the neonates were born mature and had normal body mass.
Conclusion: Solitary kidney is not contraindication to pregnancy while pyelonephritis exacerbation--to abortion. Pregnancy is contraindicated in chronic renal failure.