title: Pregnancy in women with Alport syndrome.
abstract: BACKGROUND
  Little is known about pregnancy in women with Alport syndrome (AS), as only four cases have been reported in the literature. We herein describe the course of pregnancy in two sisters with overt forms of AS.
  
  
  METHODS
  Both women were diagnosed as having autosomal recessive AS. Before pregnancy, their renal function and their blood pressure were normal, and proteinuria values were below 2 g/24 h. Both patients faced a progressive and remarkable increase in proteinuria during pregnancy, with subsequent hypoproteinemia. The clinical condition worsened, particularly in the first case, who was managed with some success with a combination of diuretics. She delivered at 32 weeks of pregnancy. The second patient was less challenging and she delivered at 36 weeks. Proteinuria returned to pre-pregnancy levels in both cases, after delivery.
  
  
  CONCLUSIONS
  Management of pregnant women with overt AS is challenging and worsening of renal disease has to be expected. The use of diuretic therapy may be of benefit.
authors.affiliation: Department of Obstetrics and Gynecology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via Commenda, 12, 20122, Milan, Italy. franci.crovetto@gmail.com
authors.forename: Francesca
authors.initials: F
authors.lastname: Crovetto
authors.forename: Gabriella
authors.initials: G
authors.lastname: Moroni
authors.forename: Barbara
authors.initials: B
authors.lastname: Zaina
authors.forename: Barbara
authors.initials: B
authors.lastname: Acaia
authors.forename: Manuela W
authors.initials: MW
authors.lastname: Ossola
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
mesh_terms: D000293:Adolescent; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007677:Kidney Function Tests; D009394:Nephritis, Hereditary / Q000150:complications* / Q000175:diagnosis; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000379:methods; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D018570:Risk Assessment; D035781:Siblings; D013148:Spironolactone / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D013148:Spironolactone