Diagnosis and treatment of nephrotic syndrome during pregnancy.

Abstract

OBJECTIVE To set forth the methods of diagnosis and treatment of nephrotic syndrome during pregnancy (NSP) so as to decrease perinatal mortality. MATERIALS AND METHODS Forty cases of NSP including 5 twins in Tianjin Central Hospital of Obstetrics and Gynecology in the past 13 years have been reviewed, and the diagnosis and treatment were compared between group A (1979-1990, 23 cases) and group B (1991-1992, 17 cases). RESULTS NSP occurred before the 20th gestational week in 15% of cases and the patient's condition was serious. Clinically, NSP was classified into three types: simple, nephritis and pregnancy induced hypertension (PIH) type. The perinatal maternal and fetal prognosis was poor. Complications occurred in 27.5% of patients. One patient died from eclampsia and disseminated intravascular coagulation (DIC). The total perinatal mortality was 42.22%, with group A (27 babies including 4 twins), 51.86% (14/27), and group B (18 babies including 1 twin), 27.78% (5/18) (P < 0.01). CONCLUSIONS NSP is a result of reproductive immunology and belongs to type III allergic reaction in terms of immunology. Early diagnosis, early treatment and timely termination of pregnancy may improve the outcome.

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