Focal segmental glomerulosclerosis and pregnancy: a case report

Abstract

Chronic kidney disease (CKD) is seen in approximately 3% of women of childbearing age. Focal segmental glomerulosclerosis (FSGS) is the most common glomerular disorder that causes end stage renal disease (ESRD). It commonly presents with nephrotic syndrome which increases the risk of pregnancy complications. We report successful pregnancy outcome in a young woman with FSGS and nephrotic syndrome who was not on treatment till 20 weeks of gestation. Antihypertensives and immunosuppressants were titrated. Strict antepartum fetal surveillance and follow-up with nephrologist were done. Caesarean section was performed at 32 weeks because of rising proteinuria despite therapy and IUGR. Post-operative recovery was uneventful. Resolution of proteinuria is the cornerstone in the management of FSGS as this delays the progression of the disease.