Imbasciati E, Surian M, Bottino S, Cosci P, Colussi G, Ambroso G C, Massa E, Minetti L, Pardi G, Ponticelli C
Nephron. 1984;36(1):46-51. doi: 10.1159/000183114.
We describe 26 pregnancies in 19 patients with lupus nephritis. There were 4 spontaneous abortions, 2 therapeutic abortions, 4 stillbirths and 1 neonatal death. 10 deliveries were preterm and 2 fetuses were small for gestational age. 8 pregnancies were not accompanied by change of renal symptoms. Mild signs of renal involvement appeared during pregnancy in 4 patients. 6 patients showed an increase in proteinuria already present before pregnancy without renal function deterioration. A moderate worsening of renal function was observed in 3 patients. 4 patients, 3 of whom had an apparent onset of systemic lupus erythematosus during pregnancy, developed anuric acute renal failure after delivery or after late spontaneous abortion. 2 of them died from sepsis and disseminated intravascular coagulation while 2 had complete recovery of renal function. A high rate of complications was observed in patients not adequately treated during pregnancy. Renal biopsy before gestation was not predictive of the outcome of nephropathy during pregnancy, and change of histology in repeated biopsies was frequently observed.
我们描述了19例狼疮性肾炎患者的26次妊娠情况。其中有4例自然流产、2例治疗性流产、4例死产和1例新生儿死亡。10例分娩为早产，2例胎儿小于孕周。8次妊娠未伴有肾脏症状改变。4例患者在孕期出现轻度肾脏受累体征。6例患者孕期蛋白尿较妊娠前已有增加，但肾功能未恶化。3例患者出现肾功能中度恶化。4例患者（其中3例在孕期明显起病为系统性红斑狼疮）在分娩后或晚期自然流产后发生无尿性急性肾衰竭。其中2例死于败血症和弥散性血管内凝血，另2例肾功能完全恢复。孕期未得到充分治疗的患者并发症发生率较高。妊娠前的肾活检不能预测孕期肾病的结局，且重复活检时组织学改变较为常见。
