Abstract
Objectives Evaluation of outpatients with glomerupathies who had pregnancy complicated by arterial hypertension. Methods Retrospective study with 52 women who started monitoring of glomerulonephritis during the period of 1989–2014 at outpatient clinics of UNIFESP, Sao Paulo/Brazil and who had pregnancy complicated by arterial hypertension. Results Women ranged from age 15 to 52 years old ± 7.83 (mean 30.67). A total of 88.5% (46/52) had a pregnancy with a hypertensive syndrome, 11.5% (6/52) eclampsia, 1.9% (1/52) HELLP syndrome, 75.0% (39/52) preeclampsia or pregnancy-induced hypertension. The other 11.5% (6/52) had previous kidney disease that had an acute exacerbation or was only manifested during pregnancy. The majority 86.5% (45/52) developed hypertension with proteinuria and/or hematuria after pregnancy; 7.7% (4/52) had clinical and laboratory remission after delivery, but later had progression to glomerulonephritis. About 7.7% (4/52) had late abortions, 30.8% (16/52) preterm birth, 7.7% (4/52) fetal death, and 3.8% (2/52) neonatal death. Renal biopsy was performed in 71.1% (37/52), renal transplant in 5.8% (3/52) and hemodialysis in 7.7% (4/52). The diagnoses were focal segmental glomerulonephritis in 13.5% (7/52), mild lesion 5.6% (3/52), membranoproliferative glomerulonephritis 13.5% (7/52), IgA nephropathy 5.6% (3/52), lupus nephritis 13.5% (7/52), other nephropathies 48.0% (25/52). Outpatient dropout was 43.4% (21/52). ambulatory discharge 3.8% (2/52) and 55.8% (29/52) kept follow up. Only 12.9% (4/31) of patients who kept follow up had worsening of renal function. Conclusions Women who had a pregnancy complicated with arterial hypertension, specially preeclampsia, may have a worse maternal and fetal/neonatal outcome and they may develop glomerulopathies in the long run. Monitoring by a nephrologist allows early diagnosis, preventing depletion of renal function. Table 1. Diagnoses during pregnancy in women under outpatient follow up for glomerulonephritis (%). % (n) of outpatients under monitoring for glomerulonephritis (n = 52) Eclampsia 11.5% (6) HELLP syndrome 1.9% (1) Preeclampsia/pregnancy-induced hypertensive 75% (39) Previous kidney disease 11.5% (6) Disclosures T.A. Facca: None. A.R. Sabino: None. J. Sato: None. E.A. Fama: None. G.S. Junior: None. G. Mastroianni-Kirsztajn: None. N. Sass: None.
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