Enfermedades glomerulares durante la gestación. Serie de casos y revisión de la literatura
DOI:
https://doi.org/10.18597/rcog.399Palabras clave:
biopsia renal, embarazo, enfermedad glomerular, gestación, glomerulopatías, hispánicasResumen
Objetivos: determinar las glomerulopatías más frecuentes y su curso clínico en mujeres gestantes. Hacer una revisión de la literatura del tema.
Materiales y métodos: serie de casos retrospectivos de pacientes gestantes con enfermedad glomerular activa diagnosticada por biopsia, entre enero de 2000 y septiembre de 2007, atendidas en el Hospital San Vicente de Paúl de Medellín, Colombia. No hubo exclusiones. Se determinaron sus características clínicas, la evolución de la enfermedad glomerular y el resultado materno perinatal.
Resultados: se hizo el diagnóstico en 11 pacientes. Cuatro casos de nefritis lúpica, dos de glomerulonefritis rápidamente progresiva (GNRP) por GN extracapilar y granulomatosis de Wegener, respectivamente; tres con síndrome nefrótico por glomeruloesclerosis focal y segmentaria (GEFyS), una con GN membrana proliferativa tipo I, y una con GN proliferativa mediada por complejos inmunes. En dos casos se presentó eclampsia. En tres casos hubo muerte materna: dos por eclampsia y una por granulomatosis de Wegener; y en tres casos muerte fetal: dos por eclampsia y una en materna con nefritis lúpica y síndrome antifosfolípido. Las glomerulopatías primarias no mostraron empeoramiento durante la gestación.
Conclusiones: en casos de GN durante la gestación hay riesgo incrementado de complicaciones materno-fetales.
Biografía del autor/a
Jorge Gómez-Jiménez
Luis Arias
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