THE NEPHROTIC SYNDROME IN PREGNANCY

Kidney disease and pregnancy

The course of 41 pregnancies was studied in 25 patients with renal disease. Histological classification of the disease in each patient was made by renal biopsy. The analysis suggests that the course of pregnancy in women with coexistent renal disease correlates with the underlying renal lesion and probably with the glomerular filtration rate and blood pressure. In patients with heavy proteinuria there is increased oedema formation, making the nephrotic syndrome a frequent complication.

Pregnancy and the nephrotic syndrome

Nineteen patients with nephrotic syndrome, 13 with histological diagnosis, were studied throughout 31 pregnancies. Eight were diagnosed for the first time during pregnancy.Antenatal problems due to severe oedema, urinary tract infection, and refractory orthochromic anaemia were encountered. Eight patients were hypertensive at booking, and in two of these pregnancy was terminated; three others had a significant increase in blood pressure. In 12 of the remaining pregnancies a rise in blood pressure of 20 mm. Hg or more occurred towards term.There were 29 live births (including one set of twins), one stillbirth due to a cord accident, and one neonatal death. The infant birth weight, apart from being affected by hypertension, was related to the maternal serum albumin level.The patients have been under observation for up to 20 years. Fifteen have not shown any deterioration of renal function during the prolonged period of observation. One developed oliguric renal failure immediately post partum and three others died, two, four, and 12 years after their pregnancies.