Pregnancy and Renal Disease A Ten‐Year Survey

Mackay, E. V.

doi:10.1111/j.1479-828x.1963.tb00210.x

Cited by 92 publications

(30 citation statements)

References 26 publications

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“…Excluding the therapeutic abortions, the 76% fetal sur vival was substantially higher than previously reported [1][2][3] and was slightly lower than that observed in a large retrospective series of women with glomerular disease without overt renal insufficiency [7]. Five of the 15 fetuses who reached a viable gestational age were small for date, but only 2 of them were lost because of severe intrauterine growth retardation.…”

Section: Discussionmentioning

confidence: 45%

“…Fetal losses as high as 79% have been reported in this condition [1,2] and it has been suggested that pregnancy may promote a rapid worsening of renal function leading to terminal renal failure [3]. However, only incomplete information about the natural history of the renal disease before pregnancy is available in these reports.…”

Section: Introductionmentioning

confidence: 70%

“…However, the large majority of patients included in these studies had normal renal function or only mild renal insufficiency at the beginning of pregnan cy. In the few reports of pregnancies in patients with overt renal function deterioration, it was concluded that preg nancy induced a worsening of the renal disease [1][2][3]. However, this opinion was based only on the follow-up data of a few patients, often inadequately studied and without any consideration of the natural history of the disease before pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few reports [1][2][3] have described the course of pregnancy in women with chronic renal failure (CRF). Fetal losses as high as 79% have been reported in this condition [1,2] and it has been suggested that pregnancy may promote a rapid worsening of renal function leading to terminal renal failure [3].…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in Women with Chronic Renal Failure

Imbasciati

Pardi²,

et al. 1986

Am J Nephrol

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We describe 19 pregnancies in 18 women with chronic renal disease and plasma creatinine ≥1.6 mg/dl before pregnancy. There were 2 spontaneous abortions (11th and 21st week), 2 therapeutic abortions (18th and 19th week), 1 stillbirth (30th week), 1 neonatal death (31st week) and 13 live births, 7 of them were preterm. Nine cesarean sections were done. Serial determinations of plasma creatinine during pregnancy showed a trend to decrease during the first half and to increase during the second half of pregnancy. The effect of pregnancy on the progression of renal failure was evaluated in 14 patients by comparing the linear regression lines of reciprocal plasma creatinine versus time before and after pregnancy. In 5 patients the rate of progression worsened after pregnancy. Our data indicate that women with chronic renal failure may have a successful pregnancy, but one third of them will have an accelerated rate of progression of the disease.

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Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pregnancy in Women with Chronic Renal Failure

Imbasciati

Pardi²,

et al. 1986

Am J Nephrol

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“…Early studies [1][2][3][4] sug gested the prognosis was unfavorable; however, more recent evidence suggests that, in the absence of decreased renal function or severe hypertension, the incidence of major complications is minimal and survival is good [5][6][7][8][9][10]. In women with glomerular disease who have normal renal function and normal blood pressure, the only signif icant risk factor associated with pregnancy is an increased risk of preeclampsia and the ultimate prognosis is un changed when compared to normal pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Postpartum Renal Failure in a Patient with Membranoproliferative Glomerulonephritis Type II

Leichter¹,

Jordan²,

Cohen³

et al. 1986

Am J Nephrol

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The previously reported detrimental effects of pregnancy on the course of membranoproliferative glomerulonephritis type II (MPGN type II) are limited and are usually considered to be mild. Based on these reports, a 19-year-old female with the diagnosis of MPGN type II who had stable renal function (creatinine 0.9 mg/dl) and a mild nephrotic syndrome with hypertension for 5 years of close follow-up was advised to complete her pregnancy. After a full-term pregnancy, complicated only by moderate nephrotic syndrome, a healthy female infant was born. Two weeks after delivery, the patient presented with acute renal failure and malignant hypertension, without evidence of hemolysis of hepatic failure. Immunologic parameters, including, C3, C4, antinuclear antibodies, circulating immune complexes as well as antibodies to glomerular basement membrane antigen and tubular basement membrane antigen were negative. Peritoneal dialysis was initiated and a renal biopsy was performed which showed MPGN type II with 50% crescents. Despite pulse therapy with methylprednisolone, renal function did not improve, resulting in the need for chronic dialysis. Although no specific nephritogenic mechanism was shown, the course of this patient should be considered when counseling female patients with MPGN type II, regarding the possibility of pregnancy exacerbating their disease, or resulting in rapidly progressive renal failure.

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