DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172376

Maternal and perinatal outcome in a pregnancy with nephrotic syndrome

Vineet Mishra, Himani Agarwal, Sunita Lamba, Sumesh Chaudhary, Priyankur Roy, Sugandha Goel

Abstract


The influence of pregnancy on the subsequent course of pre-existing nephrotic syndrome is controversial as also the effect of membranous glomerulonephritis on maternal and perinatal outcome. We describe a case of successful pregnancy outcome in Hepatitis B reactive patient with pre-existing nephrotic syndrome (renal biopsy proven case of Membrano-proliferative Glomerulonephritis). She had regular nephrology consultation and her renal disease was well compensated. After sonographic confirmation of live intrauterine pregnancy at 9th gestational week, patient was given methylprednisolone (5mg once daily). Antihypertensive drugs were also given. At 35 weeks of gestation, patient went in labour and cesarean section was performed in view of previous caesarean section. Feto-maternal outcome was good. The intrapartum and postpartum period was uneventful. Renal functions were well preserved. A vigourous healthy 1.93 kg baby was discharged with mother in a stable condition after receiving hepatitis B immunoglobulin.


Keywords


Feto-maternal outcome, Membrano-proliferative glomerulonephritis, Methylprednisolone, Nephrotic syndrome, Pregnancy

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References


Kincaid-Smith P, Fairley KF. The differential diagnosis between pre-eclamptic toxemia and glomerulonephritis in patients with proteinuria during pregnancy. Perspect Nephrol Hypertens. 1976;5:157-67.

Cohen AW, Burton HG. Nephrotic syndrome due to pre-eclamptic nephropathy in a hydatidiform mole and coexistent fetus. Obstet Gynaecol. 1979;53:130-4.

Jungers P, Houillier P, Forget D. Influence of pregnancy on the course of primary chronic glomerulonephritis. Lancet. 1995;346:1122-4.

Packham DK, North RA, Fairley KF, Whitworth JA, Kincaid-Smith P. Membranous glomerulonephritis and pregnancy. Clin Nephrol. 1987;28:56-64.

Hayslett JP, Reece EA. Managing diabetic patients with nephropathy and other vascular complications. Baillieres Clin Obstet Gynaecol. 1994;8:405-24.

Nevis IF, Reitsma A, Dominic A. Pregnancy outcomes in women with chronic kidney disease: A systematic review. Clin J Am Soc Nephrol. 2011;6: 2587-98.

Park EJ, Jung H, Hwang J. Pregnancy outcomes in patients with systemic lupus erythematosus: A retrospective review of 62 pregnancies at a single tertiary center in South Korea. Int J Rheum Dis. 2014;17:887-97.

Liu Y, Ma X, Lv J. Risk factors for pregnancy outcomes in patients with IgA nephropathy: A matched cohort study. Am J Kidney Dis. 2014;64: 730-6.

Park-Wyllie L, Mazzotta P, Pastuszak A. Birth defects after maternal exposure to corticosteroids: Prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000;62:385-92.

Guller S, Kong L, Wozniak R. Reduction of extracellular matrix protein expression in human amnion epithelial cells by glucocorticoids: a potential role in preterm rupture of the fetal membranes. J Clin Endocrinol Metab. 1995;80:2244-50.

Studd JW, Blainey JD. Pregnancy and the nephrotic syndrome. BMJ. 1969;1:276-80.