Nephrotic Syndrome in the Third Trimester of Pregnancy: A Case in Sub-Saharan Africa and a Review of the Literature

Abstract

Nephrotic syndrome occurs very rarely during pregnancy, involving about 0.012 to 0.025% of all pregnancies. We present a rare case of nephrotic syndrome at the 35th week of pregnancy. The patient was referred to the Nephrology Department by her gynecologist for progressive lower extremity edema. The initial laboratory assessment revealed proteinuria (6 g/24h), protidemia (45 g/l) and hypo-albuminemia (10 g/l) without hematuria or kidney failure. Her blood pressure was within normal range. Obstetrical ultrasound revealed an ongoing singleton pregnancy at 35 weeks of gestation without fetal or placental abnormalities. A multidisciplinary team, including a nephrologist and a gynecologist, was necessary to decide the set of interventions, considering the risks of teratogenicity, hypotrophy and fetal death. Fetal extraction was decided to be performed at 36 weeks and resulted in the delivery of a 2.3kg baby.