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[216-POS]: The importance of nephrologist follow-up during and after pregnancy complicated with preeclampsia.
Pregnancy Hypertension 2015 January
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 52years 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.
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.
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 52years 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.
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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