Pregnancy and cystinuria.

46 pregnancies in patients with cystinuria treated with a high fluid intake alone or in combination with D-penicillamine resulted in 41 normal births. New stones formed in 18 pregnancies, with stone passage early in 4 of them. No patient required stone removal during pregnancy. Other pregnancy-related problems included hypertension and urinary-tract infection, which responded to conventional management. Assiduous maintenance of a sustained high fluid intake is even more important than usual during pregnancy and the puerperium. D-penicillamine appears relatively safe for severe cases, although most patients can be managed without it. With careful medical management stone-forming cystinurics can be safely conducted through pregnancy without increased risks to the mother or fetus.