Two Pregnancies with a Different Outcome in a Patient with Alport Syndrome
Journal
Open Access Macedonian Journal of Medical Sciences
Date Issued
2016-09-15
Author(s)
DOI
https://doi.org/10.3889/oamjms.2016.073
Abstract
BACKGROUND: Alport syndrome is a genetic disease that progresses to chronic kidney failure,
with X-linked, autosomal dominant or autosomal recessive type of inheritance. Women are
generally carriers of the mutation and have a milder form of the disease. During pregnancy, they
have an increased risk of impaired kidney function and preeclampsia.
CASE PRESENTATION: A 27-year old woman, gravida 1, para 0, in her 23rd gestational week
came to the outpatient unit of the University Clinic of Nephrology for the first time because of slowly
progressing proteinuria and Alport syndrome. She was admitted to the gynaecological ward in her
29th gw for proteinuria which increased from 3.8 g/day up to 20 g/day and the serum creatinine
increased to 120- 150 micromol/l. She was delivered in the 30th gestational week due to obstetrical
indications with a cesarian section and delivered a baby with a birth weight of 880 g. After delivery,
proteinuria decreased to 2 g/d within 2 months and an angiotensin-converting enzyme inhibitor
(ACEI) was started. Her second pregnancy, after 2 years, had an uneventful course and she
delivered a healthy baby weighing 3000 g in the 39th week. Six months after the second delivery,
her renal function remained normal and her proteinuria was 2 g/d.
CONCLUSIONS: Pre-pregnancy counselling and frequent controls during pregnancy are necessary
for women with Alport syndrome, as well as regular monitoring after delivery. Recent reports are
more in favour of good pregnancy and nephrological outcomes in women with Alport syndrome
when renal disease is not advanced.
with X-linked, autosomal dominant or autosomal recessive type of inheritance. Women are
generally carriers of the mutation and have a milder form of the disease. During pregnancy, they
have an increased risk of impaired kidney function and preeclampsia.
CASE PRESENTATION: A 27-year old woman, gravida 1, para 0, in her 23rd gestational week
came to the outpatient unit of the University Clinic of Nephrology for the first time because of slowly
progressing proteinuria and Alport syndrome. She was admitted to the gynaecological ward in her
29th gw for proteinuria which increased from 3.8 g/day up to 20 g/day and the serum creatinine
increased to 120- 150 micromol/l. She was delivered in the 30th gestational week due to obstetrical
indications with a cesarian section and delivered a baby with a birth weight of 880 g. After delivery,
proteinuria decreased to 2 g/d within 2 months and an angiotensin-converting enzyme inhibitor
(ACEI) was started. Her second pregnancy, after 2 years, had an uneventful course and she
delivered a healthy baby weighing 3000 g in the 39th week. Six months after the second delivery,
her renal function remained normal and her proteinuria was 2 g/d.
CONCLUSIONS: Pre-pregnancy counselling and frequent controls during pregnancy are necessary
for women with Alport syndrome, as well as regular monitoring after delivery. Recent reports are
more in favour of good pregnancy and nephrological outcomes in women with Alport syndrome
when renal disease is not advanced.
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Two Pregnancies with a Different Outcome in a Patient with Alport Syndrome
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