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Kidney Week

Abstract: PO2607

The Ethics of Caring for Pregnant Patients with CKD: A Scoping Review

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Hendren, Elizabeth M., University of Toronto, Toronto, Ontario, Canada
  • Hladunewich, Michelle A., University of Toronto, Toronto, Ontario, Canada
  • Lefkowitz, Ariel, University of Toronto, Toronto, Ontario, Canada
Background

Physicians must consider many ethical principles when managing patients with chronic disease before and during pregnancy. An ethical framework could guide joint decision making between physicians and their patients, but does not currently exist.

Methods

We performed a scoping literature review to explore the ethical considerations associated with pregnancy in patients with chronic disease. We searched for articles published between 1975 and 2019 using the terms “Ethics” and “High risk Pregnancy/Pregnancy” along with 29 chronic disease-specific MeSH terms (e.g. scleroderma, diabetes, cystic fibrosis).

Results

We identified 968 articles and excluded 947 based on their title or abstract. 12 full text articles were included in the final scoping review representing discussions, case reports, and literature reviews on the ethics of high-risk pregnancy in 8 chronic diseases. The extracted data were examined and integrated into analyses of clinical cases in order to develop recommendations for ethically caring for this patient population.

Conclusion

Physicians have an ethical duty to their patients to facilitate autonomous decision-making and informed consent. Secondarily, they have a duty to protect the fetus and to use resources judiciously as long as it does not negatively impact the care they provide to their patient.