Nephrotic Syndrome in Pregnancy - Case Reports

Abstract

Nephrotic syndrome is a spectrum of kidney disorders with clinically significant proteinuria, peripheral oedema, hypertension, hypoalbuminemia, hyperlipidaemia, and hypercoagulable state. Pregnancy complicated with nephrotic syndrome poses significant challenges leading to maternal and foetal morbidity even in the absence of significant renal impairment. It leads to preeclampsia, foetal growth restriction, preterm birth and higher incidence of operative deliveries. Multidisciplinary approach involving high risk pregnancy team, nephrologist and neonatal care can improve neonatal and maternal outcomes. Here are the case reports of nephrotic syndrome managed with multidisciplinary approach with successful outcomes. Proteinuria in pregnancy is common ranging from mild increase to significant proteinuria. If there is significant increase it does not always necessarily be preeclampsia, it could be an underlying renal disorder. It is characterized by proteinuria in excess of over 3.5 g/day, peripheral oedema, hyperlipidaemia, hypoalbuminemia. Renal biopsy may reveal microscopic abnormalities. Prompt diagnosis, and multidisciplinary management can lead to successful outcomes. Here we are presenting case reports on pregnancies complicated with gross proteinuria which were managed with multidisciplinary inputs with positive outcomes.