[Clinical studies of IgA nephropathy during pregnancy]

We have obtained some new findings from the observation and management of 15 pregnancies and deliveries, all complicated with IgA nephropathy, which was diagnosed by open renal biopsy before each pregnancy. The classification of IgA nephropathy was from Grade I to Grade IV according to Nomoto et al. Clinical and pathological changes during each pregnancy were observed in the appearance and degree of edema, proteinuria and hypertension. The criteria were based on the classification of toxemia of pregnancy of the Committee for Toxemia of Pregnancy. Japan Society of Obstetrics and Gynecology. We referred to laboratory data such as complete blood counts, coagulation tests, blood chemistry tests, urinalysis and renal function tests. We also referred to Amagasaki's criteria which indicate whether the pregnancy and delivery will be normal or not. Three cases with Grade I IgA nephropathy all had normal courses. Nine cases with Grade II satisfied the criteria of Amagasaki for normal delivery, but during the third trimester, proteinuria was recognized in seven cases, edema in one case and hypertension in two cases. Three cases with Grade III were all met the criteria for abnormal pregnancy and delivery. Only one case showed proteinuria from the first trimester, but she had no obstetrical complications or deterioration of renal function during her course. There were 12 vaginal deliveries and three Cesarian sections. All infants were in good condition except for one intrauterine fetal death. In view of the above results, we concluded that patients with Grade II IgA nephropathy could not continue their pregnancies safety. However, some of the patients with Grade III had successful deliveries.(ABSTRACT TRUNCATED AT 250 WORDS)