Pregnancy in Patients with Renal Disease

Abstract

. The outcome of pregnancy for both mother and child was studied in 30 patients with renal disease. Glomerulonephritis had been verified by biopsy before pregnancy in 20 patients, three had severe chronic pyelonephritis, two polycystic renal disease and five had undergone a renal transplantation. Morphological or clinical preconception predictors of a riskful pregnancy were hypertension and renal functional impairment and, in the patients with glomerulonephritis, a biopsy finding known to indicate a poor or guarded prognosis in the non-pregnant state or as judged from the patient's poor response to corticosteroid therapy. However, none of the patients with glomerulonephritis, pyelonephritis or polycystic renal disease who had conceived while their renal function was normal showed any evidence, during pregnancy, of a deterioration of this function. Among 29 pregnancies in the 20 patients with a history of glomerulonephritis, 5 foetuses were lost. No abortions occurred in the other patient groups. Six children were born to the five patients with a renal transplant. All these patients received immunosuppressive therapy during pregnancy. No newborn was malformed. In one patient with hypertension and renal insufficiency at the start of pregnancy, a progressive renal insufficiency developed and haemodialysis was started after delivery. In most instances, the counseling of women with pre-existing renal disease who want to have children can be guardedly optimistic.