Clinical Expert Series
Chronic Renal Disease in Pregnancy
Susan M. Ramin, MD, Alex C. Vidaeff, MD, Edward R. Yeomans, MD, and Larry C. Gilstrap III, MD
Obstet Gynecol 2006;108:1531–9
ACCME Accreditation
The American College of Obstetricians and Gynecologists (ACOG) is accredited by the Accreditation Council for Continuing
Medical Education (ACCME) to provide continuing medical education for physicians. (Continuing medical education credit for
“Chronic Renal Disease in Pregnancy” will be available through December 2009.)
AMA PRA Category 1 CreditTM and ACOG Cognate Credit
The American College of Obstetricians and Gynecologists (ACOG) designates this educational activity for a maximum of 2
AMA PRA Category 1 CreditsTM or up to a maximum of 2 Category 1 ACOG cognate credits. Physicians should only claim
credit commensurate with the extent of their participation in the activity.
Disclosure Statement
Current guidelines state that continuing medical education (CME) providers must ensure that CME activities are free from the
control of any commercial interest. All authors, reviewers, and contributors have disclosed to ACOG all relevant financial
relationships with any commercial interests. The authors, reviewers, and contributors declare that neither they nor any business
associate nor any member of their immediate families has financial interest or other relationships with any manufacturer of
products or any providers of services discussed in this program. Any conflicts have been resolved through group and outside
review of all content.
To obtain credits, complete and return this form via one of two methods: e-mail (cognates@acog.org) or fax (202-484-1586). If
you are sending this form via e-mail, please save the document to your computer and e-mail it as an attachment. Credit will be
automatically recorded upon receipt and online transcripts will be updated twice monthly. ACOG Fellows may check their
transcripts online at http://www.acog.org. Please be sure to retain this form as confirmation of your program participation. If you
are not an ACOG member, it is not necessary to send a copy of your completed form to us.
1. When a woman has moderate-to-severe chronic renal insufficiency during pregnancy, the chance that
she will experience end-stage renal failure within the subsequent year is approximately:
0.5%
1%
5%
15%
25%
2. In a study by Cunningham and associates, the most common complication of pregnancy seen in
women with severe renal disease was:
Prematurity
Preeclampsia
Anemia
Chronic hypertension
Macrosomia
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2006;108:1531–9
Credit available through December 2009
Page 1 of 3
3. When both renal disease and hypertension complicate a conception, the risk of fetal loss is increased
by a factor of approximately:
1.5
2
4
8
10
4. When significant proteinuria (greater than 500 mg per day) is detected in an asymptomatic pregnant
woman without diabetes, renal insufficiency will be present in approximately what percent of cases?
30%
45%
60%
75%
90%
5. A patient presented for routine prenatal care at approximately 16 weeks of gestation. Initial screening
demonstrated proteinuria and subsequent evaluation found the patient to have a serum creatinine level
of 2.2 mg/dL. This patient should be counseled that she has a risk of developing end-stage renal
disease within a year of delivery that is approximately:
1 in 5
1 in 4
1 in 3
1 in 2
1 in 1 (100%)
6. The target of antihypertensive therapy in the presence of underlying renal disease is to maintain
diastolic blood pressure at or below:
60 mm Hg
70 mm Hg
80 mm Hg
90 mm Hg
100 mm Hg
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2006;108:1531–9
Credit available through December 2009
Page 2 of 3
7. List any changes, if any, that you will make in your practice as a result of reading this article:
ACOG ID Number:
Name:
Address:
City/State/Zip:
Actual time spent completing this activity (you may record up to 2 hours):
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2006;108:1531–9
Credit available through December 2009
Page 3 of 3