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題名 | Pregnancy in Patients with Primary Glomerulonephritis=懷孕與原發性腎小球腎炎 |
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作者 | 劉益坊; 徐國雄; 吳明儒; 鄭志雄; 連榮達; | 書刊名 | 中華民國腎臟醫學會雜誌 |
卷期 | 11:1 1997.03[民86.03] |
頁次 | 頁20-26+52 |
分類號 | 415.812 |
關鍵詞 | 懷孕; 原發性腎小球腎炎; Pregnancy; Primary glomerulonephritis; |
語文 | 英文(English) |
英文摘要 | To clarify the outcome of pregnancy in patients with primary glomerulonephritis (GN) and the impact of pregnancy on renal function of these patients, we retrospectively reviewed the medical charts of childbearing-age females who underwent renal biopsy at our hospital in the past 13 years. A total of 420 charts were screened but only 40 pregnancies undertaken by 28 women who had adequate follow-up data were available and formed the basis of the analysis. There were 15 women /23 pregnancies in IgA nephropathy (IgA N) group, 7 women/10 pregnancies in mesangial proliferative GN (Mes P GN) group, 6 women /7 pregnancies in focal segmental glomerulosclerosis (FSGS) group. The average age of mothers at conception was 29.3 ± 4.2 years. The average body weight of total live-births was 2889.5 ± 768.7g. About fetal outcome, there were 1 therapeutic abortion, 4 spontaneous abortions, 2 still births, 2 neonatal deaths, 1 premature and 13 terms in the group of IgA N. There were 1 therapeutic abortion and 9 terms in the group of Mes P GN. There were 2 prematures and 5 terms in the group of FSGS. Poor fetal outcome (defined by therapeutic abortion, spontaneous abortion, still birth or neonatal death) was encountered in 39% pregnancies of IgA N group. A serum creatinine >1.4 mg/dl during the course of pregnancy was correlated with a poor fetal outcome. Pregnancy caused the deterioration of renal function in 13 pregnancies (56.5%) in IgA N group including 3 women (20%) with irreversible renal failure. Deterioration of renal function was recorded on 4 pregnancies of Mes P GN. 1 woman (14.5%) of those with Mes P GN had irreversible renal failure. Deterioration of renal function was seen in only one pregnancy of FSGS but no irreversible renal failure was recorded on FSGS mothers. The diastolic blood pressure > 90 mmHg or systolic blood pressure > 140 mmHg during the course of pregnancy was correlated with high risk of maternal renal insufficiency. We conclude that pregnancy in IgA N patients might carry high risk to both poor fetal outcome and maternal renal deterioration, especially in those with the serum creatinine >1.4 mg/dl or diastolic blood pressure>90mmHg. The amount of daily urine protein loss was not correlated with a bad outcome to mothers or fetus in our study. However, further study with a larger population is mandatory to clarify this issue. |
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