OUTCOME OF PREGNANCY IN WOMEN WITH GLOMERULAR-DISEASES

Over the last 16 years the evolution of 24 pregnancies in 17 women wit h biopsy-proven glomerular disease was analyzed. The underlying renal histology was IgA nephropathy in 8 cases, lupus nephritis in 7, mesang iocapillary glomerulonephritis type I in 1, and focal segmental glomer ulosclerosis in 1. All but 2 had normal renal function before concepti on and 3 were hypertensive. Fetal survival rate was 75%. There were 6 preterm deliveries (33.3%), 3 newborns small for gestational age (17%) , I stillbirth, and 5 therapeutic abortions. The perinatal mortality w as 5.5%. De novo hypertension occurred in 8 pregnancies (33.3%). In II pregnancies (46%) increased proteinuria was diagnosed and in 6 (25%) a decline in maternal renal function was recorded. Permanent impairmen t of renal function was seen in 2 women with renal insufficiency befor e conception. Maternal hypertension and renal function impairment were associated more frequently with obstetric complications. In conclusio n, pregnancy is safe for normotensive mothers with glomerular diseases and normal renal function. Hypertension and impaired renal fraction a t conception seem to carry increased risk for mothers and fetuses. Low -dose immunosuppressive treatment during pregnancy is not harmful for the fetus.