Pregnancy and glomerulonephritis. A review Glomerulonefritis y embarazo. Revisión de tema

Abstract

<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:595.3pt 841.9pt; margin:70.85pt 3.0cm 70.85pt 3.0cm; mso-header-margin:35.4pt; mso-footer-margin:35.4pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p style="text-align: justify" class="MsoNormal"><span style="font-size: 10pt; font-family: Arial">Antecedent: Glomerulal involvement is rare during pregnancy, but the associated morbidity is serious and potentially lethal. How does it affect prognosis? Objective: To define guidelines for the care of women affected by glomerulal disease during the pregestational stage, gestationand puerperium, and the indications for dialysis and renal biopsy. Materials and methods: Analysis of textual revisions published between 1980 and 1992, and the publications of Medline between 1993 and 2007 (Pregnancy and Glomerulonephritis). Results: Few randomized controlled studies were found. Most studies were cross-sectional and cases series, but they allow the assertion that glomerulonephritis adversely affects gestational outcomes and that pregnancy favors renal damage and the lupus flare. Conclusion: The incidence of exacerbation of glomerulonephritis is higher during pregnancy and the perinatal and maternal outcomes are affected, especially in the presence of preeclampsia or antiphospholipid syndrome.</span></p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:595.3pt 841.9pt; margin:70.85pt 3.0cm 70.85pt 3.0cm; mso-header-margin:35.4pt; mso-footer-margin:35.4pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p style="text-align: justify" class="MsoNormal"><span style="font-size: 10pt; font-family: Arial">Antecedentes: la afección glomerular es rara en las gestantes, pero las complicaciones asociadas son graves y potencialmente letales. ¿Cómo el embarazo afecta su pronóstico? Objetivo: definir pautas para el cuidado de las mujeres afectadas por enfermedad glomerular durante la etapa pregestacional, la gestación y el puerperio y puntualizar las indicaciones para diálisis y biopsia renal. Materiales y métodos: analizamos revisiones textuales publicadas entre 1980 y 1992, y las publicaciones de Medline entre 1993 y 2007 (Embarazo y Glomerulonefritis). Resultados: se hallaron muy pocos estudios aleatorizados controlados.</span></p> <p style="text-align: justify" class="MsoNormal"><span style="font-size: 10pt; font-family: Arial">La mayoría de los encontrados fueron transversales y series de casos, pero sus resultados permiten afirmar que la glomerulonefritis afecta adversamente el curso de la gestación y que ésta favorece las exacerbaciones de aquélla. Conclusión: la incidencia de exacerbación de glomerulonefritis es mayor durante el embarazo y los resultados materno y perinatal se afectan, especialmente si se presenta preeclampsia o síndrome antifosfolípido.</span></p>