Packham D K, North R A, Fairley K F, Whitworth J A, Kincaid-Smith P
Department of Nephrology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Clin Nephrol. 1987 Aug;28(2):56-64.
The clinical courses of 33 pregnancies in 24 patients with biopsy proven membranous glomerulonephritis have been analyzed. Twenty-four percent (8) of pregnancies resulted in fetal loss, 43% (14) in premature delivery and 33% (11) in a live birth after 36 weeks gestation. Maternal renal function declined during pregnancy in 9% (3) of the pregnancies and in 46% (15) hypertension developed. In 55% (18) proteinuria increased significantly during pregnancy. In 30% (10) nephrotic range proteinuria was recorded in the first trimester. Presence of nephrotic range proteinuria during the first trimester correlated with both poor fetal and poor maternal outcome (p less than 0.0004 and p less than 0.0002, respectively). It is concluded that pregnancy in patients with membranous glomerulonephritis is associated with increased fetal loss and, in some instances, a worsening in maternal renal function. The literature on this topic is reviewed in relation to these findings.
对24例经活检证实为膜性肾小球肾炎患者的33次妊娠临床过程进行了分析。24%（8次）妊娠导致胎儿丢失，43%（14次）早产，33%（11次）在妊娠36周后活产。9%（3次）妊娠期间孕妇肾功能下降，46%（15次）出现高血压。55%（18次）妊娠期间蛋白尿显著增加。30%（10次）在孕早期出现肾病范围蛋白尿。孕早期出现肾病范围蛋白尿与胎儿预后不良和孕妇预后不良均相关（分别为p<0.0004和p<0.0002）。结论是，膜性肾小球肾炎患者妊娠与胎儿丢失增加相关，在某些情况下，孕妇肾功能会恶化。结合这些发现对该主题的文献进行了综述。
