Document Detail


Diabetic nephropathy: pregnancy performance and fetomaternal outcome.
MedLine Citation:
PMID:  3394754     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A study of 31 continuing pregnancies complicated by diabetic nephropathy was conducted to determine the effects of diabetes-associated renal disease on maternal health and fetal outcome. Throughout pregnancy there was a significant increase in maternal blood pressure (p less than 0.001) and proteinuria (p less than 0.0001), with nephrotic syndrome (greater than 3.0 gm protein/day) developing in 71% of pregnancies. After birth, however, proteinuria reverted to levels not significantly different from values in early pregnancy. There was no apparent adverse effect of pregnancy on the natural course of the underlying renal disease. Stillbirths occurred in two patients (6%), and the remaining 29 pregnancies resulted in live-births at a mean gestational age of 36 weeks. Seventy percent of these infants were appropriate for gestational age, whereas 16% were small and 13% were large for gestational age. Birth weight was best correlated with gestational age and creatinine clearance (p less than 0.0001). Neonatal complications included respiratory distress syndrome (19%), hyperbilirubinemia (26), and congenital malformations (10%). The uncorrected perinatal survival rate was 94%. These data suggest that with contemporary methods of maternal evaluation and treatment, fetal surveillance, and neonatal care, the risks to patients with diabetic nephropathy during pregnancy are not excessive. The likelihood of a successful fetal and neonatal outcome is comparable to that in other patients with insulin-dependent diabetes.
Authors:
E A Reece; D R Coustan; J P Hayslett; T Holford; J Coulehan; T Z O'Connor; J C Hobbins
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  159     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1988 Jul 
Date Detail:
Created Date:  1988-08-19     Completed Date:  1988-08-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  56-66     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Birth Weight
Diabetic Nephropathies / blood,  physiopathology*
Female
Follow-Up Studies
Humans
Infant, Newborn
Kidney / physiopathology
Pregnancy
Pregnancy Outcome / physiopathology
Pregnancy in Diabetics / blood,  physiopathology*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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