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Diagnosis and treatment of nephrotic syndrome during pregnancy
1Department of Maternal Fetal Medicine, Tianjin Central Hospital of Obstetrics and Gynecology.
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.