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Nephrol Dial Transplant (2002) 17: 672-674
© 2002 European Renal Association-European Dialysis and Transplant Association

Teaching Point

Nephrotic syndrome in early pregnancy—is renal biopsy always necessary?

(Section Editor: K. Kühn)

Bhavna K. Pandya1,, Simon P. Gibson1 and Iain G. Robertson2

1 Department of Renal Medicine and 2 Department of Obstetrics and Gynaecology, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, UK

Keywords: early pregnancy; hypertension; nephrotic syndrome; partial mole; pre-eclampsia; renal biopsy; triploidy

Introduction

Increased proteinuria in pregnancy is common, ranging from a slight elevation to nephrotic amounts. In early pregnancy, nephrotic proteinuria with hypertension is considered suggestive of native renal disease rather than pre-eclampsia [1]. Diagnosis and proper management are very important for maternal and fetal health [2]. Overall, glomerular lesions associated with pre-eclampsia are the commonest findings in pregnant renal biopsies and the changes are reversible without any long-term sequelae [3].

Here we present a case of early nephrotic syndrome with hypertension associated with a triploid fetus and a placenta with a partial mole. Nephrotic syndrome and hypertension resolved when the pregnancy was terminated. Renal biopsy and steroids were not required.

Case

A 24-year-old primigravid woman with oedema and hypertension was referred for nephrological opinion after an ultrasound confirmed 15 weeks of gestation. She had noticed facial and periorbital oedema at 13 weeks gestation. There was a . . . [Full Text of this Article]

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