[Management of Gitelman syndrome during pregnancy reporting 12 cases].

Autor: Elbouajaji K; Service de gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France., Blanchier D; Service de néphrologie, CH d'Angoulême, Rond-point de Girac, 16000 Angoulême, France., Pourrat O; Service de réanimation médicale, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France., Sarreau M; Service de gynécologie obstétrique, CH d'Angoulême, Rond-point de Girac, 16000 Angoulême, France. Electronic address: meliesarreau@hotmail.com.
Jazyk: francouzština
Zdroj: Nephrologie & therapeutique [Nephrol Ther] 2018 Dec; Vol. 14 (7), pp. 536-543. Date of Electronic Publication: 2018 Oct 09.
DOI: 10.1016/j.nephro.2018.06.003
Abstrakt: Introduction: Gitelman syndrome is a rare hereditary renal tubulopathy, responsable of hypokalemia and hypomagnesaemia-related ionic disorders, which management is poorly codified during pregnancy. We report 12 cases of pregnancies with Gitelman syndrome and we compare our data with those of literature.
Material and Methods: It is a report of 12 pregnancies in 5 patients with Gitelman syndrome between 2002 and 2016. Follow up and outcome of pregnancy, delivery modalities and maternal-fetal prognosis have been collected.
Results: In our serie, maximum kaliemie observed was 3.4mmol/L, with an average potassium, over all pregnancies of 2.3mmol/L. Oral potassium and magnesium supplementation at the end of pregnancy were 8900mg/day and 460mg/day, respectively. There were no serious maternal complications. Two pregnancies were complicated by intrauterine growth retardation in a context of preeclampsia. There is a large disparity in the methods of anesthetic management of these patients. Materno-fetal prognosis at 1 month post-partum is good.
Conclusion: Gitelman syndrome is a rare pathology where there is a lack of homogeneity in management of pregnancy. Monitoring of monthly ionogram is necessary. The goal is to obtain stable, non-symptomatic kaliemias, which will never be standardized even in increasing treatment. The most important is to inform and detect situations at risk of decompensation, including vomiting or the use of certain anesthetics. In agreement with literature data, monitoring of fetal growth and the amount of amniotic fluid in the third trimester is still warranted. These pregnancies require the development of a common care in multidisciplinary consultation meeting.
(Copyright © 2018 Association Société de néphrologie. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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