Pregnancy with severe preeclampsia, acute kidney injury and nephrotic syndrome
DOI:
https://doi.org/10.25077/aoj.7.1.330-337.2023Keywords:
Severe preeclampsia, acute kidney injury, nephrotic syndrome.Abstract
Background: Preeclampsia is one of the main causes of maternal death every year. Preeclampsia can have bad
consequences for both the mother and the fetus. Complications in the mother in the form of HELLP syndrome
(Hemolysis, Elevated Liver Enzyme, Low Platelet), pulmonary edema, kidney disorders, bleeding, placental
abruption and even maternal death. Complications in infants can be premature birth, fetal distress, low birth
weight or intra uterine fetal death (IUFD).
Case Report: A 34 year old female patient was brought to the emergency room of Dr. M. Djamil Padang, sent to
the Batusangkar Private Hospital with complaints of shortness of breath which has been increasing when lying
down. Physical examination found blood pressure 190/136. The patient was diagnosed with G2P1A0H1 gravid
preterm 25-26 weeks, PEB on maintenance dose MgSO4 regimen from outside, suspected nephrotic syndrome,
CAP with hypoxemia, pleural effusion, AKI with metabolic acidosis, UTI, hyponatremia, hypoalbuminemia.
Discussion: Preeclampsia, eclampsia and HELLP syndrome are serious and life-threatening conditions faced by
pregnant women. Early diagnosis and prompt treatment via a multidisciplinary team in the ICU setting can
prevent complications and reduce morbidity and mortality. The most common indications for intubation and
mechanical ventilation are respiratory failure and hemodynamic instability. The cause of death in this patient
was multiple organ failure which was exacerbated by suspected nephrotic syndrome and suspected SLE.
References
Cunningham L, Bloom, Dashe. Hypertensive Disorders. Williams Obstetric 24 ed. New York: Mc
Graw Hill; 2014. p. 1086-8
ACOG. Hypertension in pregnancy. Washington: the American College of Obstetricans and
Gynecologists; 2013 .p. 22
Sibai BM. Hypertension. In: Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux
ERM, et al, editors. Obstetrics normal and problem pregnancies. 7th ed. Philadelphia: Elsevier;
p. 661-705
Townsend, Rosemary. O’Brien, Patrick. Khalil, Asma. Current best practice in the management
of hypertensive disorders in pregnancy. Integrated Blood Pressure Control. London. 2016
Raghupathy R. 2013. Cytokines as Key Players in the Pathophysiology of Preeclampsia. Journal
Medical Principles and Practice, 22 (23), 8–19
Prodjosudjadi Wiguno. Sindrom Nefrotik. Buku Ajar Ilmu Penyakit Dalam, edisi VI. 2014. Jakarta
: Interna Publishing. Hal. 999 – 1005
National Kidney and Urologic Diseases Information Clearinghouse. Nephrotic Syndrome in
Adults. 2013
Perico N, Remuzzi A, Remuzzi G. Mechanis and Consqunces of Proteinuria. In : Brenner and
Rector’s The Kidney. 2013
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Joserizal Serudji, Haviz Yuad, Syntia Ambelina
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
Authors who publish with this journal agree to the following terms:
- Authors retain the copyright of published articles and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
License:
Andalas Obstetrics and Gynecology Journal (AOJ) is published under the terms of the Creative Commons Attribution 4.0 International License. This license permits anyone to copy and redistribute this material in any form or format, compose, modify, and make derivatives of this material for any purpose, including commercial purposes, as long as they credit the author for the original work.
