Spectrum of Renal Involvement in Patients of Obstetrical and Gynaecological Disorders associated with Renal Abnormalities

Background: The prevalence and effects of renal diseases in obstetrical and gynecological patients vary. Acute kidney injury (AKI), rapidly progressive glomerulonephritis (RPGN), chronic kidney disease (CKD), or nephrotic syndrome can all occur in patients.

Aim: The study was conducted to see the spectrum of renal involvement in patients of obstetrical and gynaecological disorders associated with renal abnormalities at our centre.

Methods: The present study was conducted in the Department of Nephrology, Gauhati Medical College and Hospital, Guwahati, Assam, India over a period of 5 years (2011 – 2015). A total of 60 patients were included in the study.

Results: Of the 60 patients, 32 (53.3%) had AKI- mostly pregnancy related, 11(18.3%) patients had obstructive uropathy, 4 (6.6%) patients were diagnosed with CKD in the antenatal period, 3 (5%) patients each of RPGN and nephrotic syndrome, 5 (8.3%) patients were diagnosed with lupus nephritis and 2 (3.3%) patients were diagnosed with genitourinary tuberculosis. Renal biopsy was done in 14 patients and showed lupus nephritis in 5 patients, cortical necrosis in 2 patients, and 1 patients each with acute tubular necrosis (ATN), minimal change disease (MCD), IgA nephropathy (IgAN), Cresentric IgAN, Pauci immune glomerulonephritis, Diffuse proliferative glomerulonephritis (DPGN) and Membranous glomerulonephritis (MGN). Acute kidney injury was quite common in the pregnant females, with septic abortion and puerperal sepsis contributing to a significant number of cases. Hence, there is a need to halt the practice of illegal abortions and improve antenatal and also post natal care to reduce morbidity and mortality.

Conclusion: AKI associated to pregnancy is rather common. If left untreated, cortical necrosis could develop. Another illness that is encountered is cervical cancer, which can lead to obstructive uropathy and chronic kidney disease. To minimize morbidity and death, an early diagnosis and suitable treatment are crucial.