妊娠合并多囊肾诊疗的围产结局分析  

Perinatal outcomes analysis of diagnosis and treatment of pregnancy with polycystic kidney

作　　者：程子怡 朱小辉[1] 闫丽盈[1] 魏瑗[1] CHENG Ziyi;ZHU Xiaohui;YAN Liying;WEI Yuan(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100083,P.R.China)

机构地区：[1]北京大学第三医院妇产科,北京100083

出　　处：《中国计划生育和妇产科》2020年第6期82-86,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的分析妊娠合并成人型多囊肾的围产结局并进行随访,为妊娠合并多囊肾的围产保健提供依据。方法回顾性分析北京大学第三医院2001年7月至2018年12月28例妊娠合并成人型多囊肾患者的病历资料,并随访母儿结局。结果28例成人型多囊肾患者共计38次妊娠,平均分娩年龄(30.4±4.1)岁,平均分娩孕周(37.5±2.6)周。孕期母体合并症的发生率明显增加,合并其他器官多囊样改变发生9例(32.1%);有妊娠合并症的26例(68.4%);足月新生儿24例(75.8%),早产8例(24.2%),新生儿平均出生体重(2718.4±751.5)g。产后随访1~17年,随访21例,其中慢性高血压6例(28.5%),蛋白尿1例(4.7%),肾功能异常4例(19.0%),终末期肾病2例(9.5%),失访7例。结论妊娠合并成人型多囊肾患者孕期母体妊娠期高血压疾病发生率显著增加,但新生儿合并症无明显增加,母体多囊肾病情进展主要源于自身病情进展,与妊娠的相关性有待进一步研究。孕期长程透析为多囊肾进展到终末期的孕妇继续妊娠提供了有效保证。Objective Analyze the perinatal outcomes of pregnancy with adult polycystic kidney disease and follow up,to provide a basis for perinatal health care of pregnancy with polycystic kidney disease.Methods The medical records of 28 pregnant women with adult polycystic kidney disease from July 2001 to December 2018 in Peking University Third Hospital were retrospectively analyzed,and the maternal and child outcomes were followed up.Results A total of 28 adult polycystic kidney disease patients had 38 pregnancies.The average age of delivery was(30.4±4.1)years,and the average gestational week of delivery was(37.5±2.6)weeks.The incidence of maternal comorbidities during pregnancy increased significantly,with other organs The incidence of polycystic changes was 9 cases(32.1%);there were 26 cases(68.4%)with comorbidities in pregnancy;24 cases(75.8%)of full-term neonates,8 cases(24.2%)of premature births,and average births of newborns weight(2718.4±751.5)g.Followed up for 1~17 years postpartum,21 cases were followed up,including 6 cases of chronic hypertension(28.5%),1 case of proteinuria(4.7%),4 cases of abnormal renal function(19.0%)and 2 cases of end-stage renal disease(9.5%).7 cases were lost to follow up.Conclusion The incidence of maternal pregnancy-induced hypertension in pregnant women with adult polycystic kidney disease increased significantly,but there was no significant increase in neonatal comorbidities.The progression of maternal polycystic kidney disease mainly stems from their own disease progression,and the correlation with pregnancy needs further study.Long-term dialysis during pregnancy provides an effective guarantee for pregnant women whose polycystic kidney disease has progressed to the end stage to continue pregnancy.

关 键 词：妊娠合并成人型多囊肾 常染色体显性多囊肾 子痫前期 妊娠期高血压疾病 

分 类 号：R714.258[医药卫生—妇产科学] R714.2[医药卫生—临床医学]