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Archives of Gynecology and Obstetrics

, Volume 293, Issue 4, pp 739–747 | Cite as

Pregnancy outcomes in patients with Alport syndrome

  • Enav Yefet
  • David Tovbin
  • Zohar Nachum
Maternal-Fetal Medicine

Abstract

Purpose

To analyze the maternal and obstetric outcomes of patients with Alport syndrome.

Methods

We describe the pregnancy course of 8 pregnancies of three family members with the autosomal dominant (the rarest) form of Alport syndrome. We also analyzed 10 previously reported pregnancies with other Alport mutations in order to explore risk factors for unfavorable obstetric outcomes and maternal renal deterioration.

Results

In 13 pregnancies (72 %), renal function did not deteriorate permanently. All of these women had pre-pregnancy mild chronic kidney disease (CKD stage G1). In all of them, only a transient increase in proteinuria was recorded and in one case there was a transient decrease in the estimated glomerular filtration rate. In four other pregnancies (22 %), renal function deteriorated following pregnancy. All of them were complicated with pre-eclampsia. One woman had pre-pregnancy CKD-G2A3 and chronic hypertension. Two women had CKD-G1A3 of whom one had pre-pregnancy proteinuria near the nephrotic range. In the fourth case, renal function deterioration was reported without information on the exact pre-pregnancy renal function. In the last case, CKD-G2 was reported after pregnancy without information on CKD stage prior to pregnancy. Severe proteinuria did not imply a permanent renal function deterioration if it developed during pregnancy. Ten pregnancies ended with preterm birth (56 %). Two stillbirths were reported (11 %); however, only one was attributed to maternal health deterioration.

Conclusion

Data regarding pregnancy outcomes in Alport syndrome is limited. The outcome seems favorable when pre-pregnancy kidney function is normal or near normal and when chronic hypertension/pre-eclampsia is absent.

Keywords

Alport syndrome Kidney disease Nephritis Pregnancy Renal failure 

Notes

Compliance with ethical standards

Details of ethics approval

Informed consent was obtained from the patient treated at our institution. All the information regarding the patients in this study is presented anonymously. This study was approved by the ethics committee.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyEmek Medical CenterAfulaIsrael
  2. 2.Department of NephrologyEmek Medical CenterAfulaIsrael
  3. 3.Rappaport Faculty of MedicineTechnionHaifaIsrael

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