Etiologies et evolution de l'insuffisance renale aigue gravidique dans un contexte de limitation des ressources : analyse des dossiers de 32 patientes a Ouagadougou (Burkina Faso)

Abstract

Le but de ce travail sur l'insuffisance renale aigue (IRA) gravidique (IRAG) etait d'en connaitre I' evolutiona court terme, ses principaux facteurs etiologiques ainsi que le devenir matemo-fretal dans le Service de Gynecologie et d'Obstetrique (SGO) du Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO). Nous avons analyse les dossiers des patientes du SGO de la periode du ler octobre au 31 decembre 2012. Ont ete incloses celles ayant une IRA survenue au cours du  deroulement de la grossesse, au decours d'un avortement ou dans la periode du postpartum. Les variables sociodemographiques, cliniques et paracliniques ont ete analysees. L'IRAG a ete observee chez 32 patientes soit 6,1 %des patientes ayant eu une  creatininernie. Leur moyenne d'age etait de 28,1 ± 6,6 ans, celle de la creatininernie de 429,9 ± 227,5 IJ.mol/L. La principale cause presumee d'IRAG etait !'hypertension arterielle (24 cas soit 75 % ; dont 19 cas de preeclampsie soit 62,4 %). Vingt-six patientes (81,3 %) ont eu une fonction renale normale ou amelioree. Une patiente est decedee (3,1 %). Des complications ont ete observees chez 21 fretus sur 27 (77,8 %). Le contexte de complication fretale etait 1a preeclampsie dans 18 cas sur 21 (85,7 %). L'IRAG est frequente au CHU-YO. Le taux de morbidite et mortalite fretales est tres eleve et souvent en rapport avec la preeclampsie. La prevention de cette demiere contribuerait de fa~on significative a la reduction de !'incidence de l'IRAG et de ses complications matemo-fretales au Burkina Faso.

Mots-cles : Burkina Faso, insuffisance renale aigue gravidique, morbidite fretale, morbidite matemelle, preeclampsie.

Etiology and evolution of pregnancy-induced acute renal failure in a context of resource limitation: 32 patients' records analysis in Ouagadougou (Burkina Faso)

The purpose of this work on pregnancy-related acute renal failure (PRARF) was to know its short-term evolution, main etiological factors and the maternal-fetal become in the Department of Gynaecology and Obstetrics (DGO) of Yalgado Ouedraogo University Hospital (YO-UH). We analyzed DGO patients' records of the period 11h October to 31 December 2012. Were included those with acute renal failure occurred during the course of pregnancy, the waning of an abortion or in the postpartum period. Sociodemographic, clinical and laboratory variables were analyzed. PRARF was observed in 32 patients or 6.1 % of patients who had a serum creatinine. Their average age was 28.1 ± 6.6 years, that of creatinine 429.9 ± 227.5 Jlmol/L. The main suspected cause ofPRARF was hypertension (24 cases or 75 %, including 19 cases of preeclampsia or 62.4 % ). Twenty-six patients (81.3 %) had normalized or improved renal function. One patient died (3.1 % ).  Complications were observed in 21 of 27 fetuses (77 .8 % ). The context of fetal complication was preeclampsia in 18 cases of 21 (85.7 %). PRARF is common on YO-UH. The rate of fetal morbidity and mortality is very high and often associated with preeclampsia. Preventing it would contribute significantly to reducing the incidence of PRARF and its maternal-fetal complications in Burkina Faso.

Keywords: Burkina Faso, Fetal morbidity, Maternal morbidity, Preelampsia, Pregnancy-related acute renal failure.