HRB Clinical Research Facility Galway, NUI, Galway, Ireland.
Adv Chronic Kidney Dis. 2013 Sep;20(5):402-10. doi: 10.1053/j.ackd.2013.06.004.
Several glomerular diseases may occur in women of childbearing age. Pregnancy in such patients should be planned when the disease has been in remission for a minimum of 6 months to minimize maternal and fetal complications. Immunosuppressive agents should be optimized before conception to include those that are safe for pregnancy. The complexity of medical management when caring for these patients calls for a multidisciplinary team approach consisting of a nephrologist, rheumatologist, obstetrician, and pharmacist. This review will address the physiological changes of pregnancy that may affect glomerular disease presentation, activity, and diagnosis; specific glomerular diseases primary and secondary to systemic diseases in the context of pregnancy; fetal and maternal complications and long-term effects; diagnosis and differential diagnosis; and treatment strategies that are considered relatively safe with respect to fetal intrauterine exposure.
许多肾小球疾病可能发生在育龄妇女中。此类患者的妊娠应在疾病缓解至少 6 个月后计划，以最大程度减少母婴并发症。在受孕前应优化免疫抑制剂，包括那些对妊娠安全的药物。在照顾这些患者时，医疗管理的复杂性需要多学科团队的方法，包括肾脏病专家、风湿病专家、妇产科医生和药剂师。这篇综述将讨论可能影响肾小球疾病表现、活动和诊断的妊娠生理变化；妊娠时与系统性疾病相关的原发性和继发性特定肾小球疾病；胎儿和母体并发症及长期影响；诊断和鉴别诊断；以及考虑到胎儿宫内暴露的相对安全的治疗策略。
