Glomerular Disease and Pregnancy

Surian, M; Imbasciati, E; Cosci, Pablo; Banfi, Giovanni; Belgiojoso, G. Barbiano di; Brancaccio, Diego; Minetti, L; Ponticelli, Claudio

doi:10.1159/000183126

Cited by 117 publications

(32 citation statements)

References 7 publications

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“…However, this is far below the 35% figure noted in the cumulative data of six studies [11]. Surian et al [7]did not note any PT delivery in their study of 8 pregnancies in MGN and the results are comparable to the present study. Out of 30 post-MGN pregnancies, there were 3 (10%) LBW babies.…”

Section: Discussionsupporting

confidence: 61%

“…In the present series, only 1 spontaneous abortion (3.3%) was noted in the post-MGN group of 30 pregnancies. Surian et al [7]in a study of 123 pregnancies in patients with primary and secondary glomerular diseases also noted no fetal loss in 8 pregnancies in patients with MGN and the lowest incidence of complications in this group of patients. In contrast, Jungers et al [4]in a series of 37 pregnancies in 17 patients with MGN noted a fetal loss of 35%, predominantly due to first trimester abortions.…”

Section: Discussionmentioning

confidence: 86%

“…On the contrary, in a study of 8 pregnancies in patients with MGN, Surian et al [7]did not find any LBW babies.…”

Section: Discussionmentioning

confidence: 89%

“…The referral of more complicated pregnancies in these studies could explain the high rate of fetal loss compared to the present study wherein the patients are followed up for all the pregnancies and deliveries in the Security Forces Hospital and those with underlying glomerulonephritis are followed in separate high-risk clinics. In cumulative data from six studies [1, 2, 7, 8, 9, 10], Lindheimer and Katz [11]noted an average live birth rate of 86.3% in patients with MGN and abortion was responsible for 12% of fetal loss.…”

Section: Discussionmentioning

confidence: 99%

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Repeated Pregnancies in Patients with Primary Membranous Glomerulonephritis

Malik¹,

Alharbi‎²,

Al-Mohaya³

et al. 2002

Nephron

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This retrospective study was carried out in patients with membranous glomerulonephritis (MGN) and repeated pregnancies, the aim being to see how one influences the other. Patients with two or more pregnancies after MGN were included in the study. Nine patients underwent 51 pregnancies (range 2–12, mean 5.6) and 30 were post-MGN (range 2–5, mean 3.2). Their ages were 27–44 (32 ± 5.7) years. The duration of follow-up was 2–10 (5.6 ± 2.5) years. The pregnancy outcome, i.e., number of full-term deliveries (FT), spontaneous abortion, preterm deliveries (PT), perinatal mortality (PM), low-birth-weight babies (LBW) and cesarean section (CS), was noted. In the pre-MGN group (n = 21), there were 20 (95.2%) live births and 1 (4.7%) abortion; none had PT, PM, LBW or CS. In the post-MGN group (n = 30), there were 27 (90%) live births, 2 (6.6%) PT, 1 (3.3%) abortion, 1 (3.3%) PM, 3 (10.0%) LBW baries and 3 (10.3%) CS. However, in comparison, there was no statistically significant difference in the pregnancy outcome between the two groups (p > 0.05 in all). Comparing the incidence of hypertension, proteinuria and serum creatinine levels between the first and the last post-MGN pregnancies, there was no statistically significant difference between the two groups. Only 1 patient developed renal insufficiency (serum creatinine 220 µmol/l) after undergoing 5 pregnancies and follow-up of 6 years. In conclusion, the outcome of repeated pregnancies in patients with MGN is good with 90% live births. Repeated pregnancies do not influence the course of MGN.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 86%

“…On the contrary, in a study of 8 pregnancies in patients with MGN, Surian et al [7]did not find any LBW babies.…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Repeated Pregnancies in Patients with Primary Membranous Glomerulonephritis

Malik¹,

Alharbi‎²,

Al-Mohaya³

et al. 2002

Nephron

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“…In women with previous MPGN, pregnancy appears to cause more obstetrical, fetal and renal complications than in other nephropathies [3]. Specifically, acute wors ening of renal function caused by superimposed rapidly progressive (crescentic) glomerulonephritis upon MPGN has been referred, with [4] or without [5] ultimate recovery.…”

Section: Discussionmentioning

confidence: 99%

Renal Thrombotic Microangiopathy in a Pregnant Patient with Membranoproliferative Glomerulonephritis

Aj¹,

Sobrado²,

Courel³

et al. 1988

Nephron

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Because glomerular diseases have an unforeseeable course during pregnancy, appropriate counseling is al ways compromised. Opposed evidence has been re ported without firm conclusions, and some risk factors are only considered as reference, e.g. serum creatinine (sCr) higher than 2 mg/dl, especially in the presence of severe hypertension.We report of a young female known to have membran oproliferative glomerulonephritis (MPGN) with stable renal function, controlled arterial pressure and moderate proteinuria, who developed a renal thrombotic microan giopathy in the later part of her second pregnancy. Case ReportA 24-year-old female, who had never taken oral contraceptives, presented at the age of 13 years with microscopic hematuria but no nephrotic proteinuria. She had normal renal function (sCr 0.6 mg/ dl) and blood pressure was 110/70 mm Hg. A percutaneous renal biopsy was performed 3 months later due to persistent urinalysis disorders. It contained 23 glomeruli, all of which were impaired, with lobulation of the tufts and marked mesangial hypercellulariiy. The capillary walls were thickened to a variable degree, and doublecontoured basement membranes were present. With Masson trich rome. deposits on the subendothelial side of the basement mem brane were observed. There were no sclerosis, crescents, nor intersti tial or vascular damage. An immunofluorescence technique was not performed. In short, it was a membranoproliferative glomerulo nephritis type 1, with subendothelial deposits.After treatment with steroids, her condition remained stable with 24-hour proteinuria 1.4 g. Seric C3 and C4 levels were normal and ANA and anti-ds-DNA antibodies negative. In 1982, she had her first pregnancy and the course as well as the delivery in February 1983 were normal without detrimental effects on nephropathy. Des pite an intrauterine device that was fitted in August 1983, she became pregnant in September. 2Vi months later, she developed high blood pressure (160/100 mm Hg) and proteinuria increased to 3 g/day without edema, but renal function was normal. Oral methyldopa I g/day was initiated. At 30 weeks of pregnancy, hematocrit was 36%, sCr 1.0 m g/dl and arterial pressure 160/105 mm Hg; hydralazine and propanolol were associated. 2 weeks later she was admitted to hospital for worsening of renal function (sCr 2.2 mg/dl), hematocrit (30%) and severe hypertension (170/120 mm Hg). The next week (33nd), sCr was 3.1 mg/dl, hematocrit 26%, and hyperten sion persisted with fundi examination grade III (K-W). A cesarean section was undertaken at this point and a premature, viable female infant of low weight (1,530 g) was born. A tubal ligature was also performed. In the postoperative course, diazoxide was prescribed and an increase of anemia (Hb 8.1 g/dl, hematocrit 23%) was observed. Signs of hemolytic activity were present: absent hapto globin level, reticulocyte count 109 x 109/l (40%o) and schistocytes 6-10%. White cell count (10 x I0V1), platelet count (138 x I0V1) and coagulation factors were normal, with plasma fibrin degrad...

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Acute Renal Failure in Pregnancy

Nk¹

1988

Arch Intern Med

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Glomerular Disease and Pregnancy

Cited by 117 publications

References 7 publications

Repeated Pregnancies in Patients with Primary Membranous Glomerulonephritis

Repeated Pregnancies in Patients with Primary Membranous Glomerulonephritis

Renal Thrombotic Microangiopathy in a Pregnant Patient with Membranoproliferative Glomerulonephritis

Acute Renal Failure in Pregnancy

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