Gitelman’s and Bartter’s syndromes in pregnancy – a systematic review

Background : Gitelman's syndrome (GS) and Bartter's syndrome (BS) are rare renal disorders causing electrolyte disturbances, with physiological changes of pregnancy potentially worsening symptoms and electrolyte derangement. Methods A literature search of electronic databases was conducted using terms describing (1) GS or BS and (2) pregnancy, and the quality of studies was graded using the NIH/NHLBI quality assessment tool. Data collected included measures of maternal and neonatal outcomes, pregnancy information, and details of treatment, diagnosis, and electrolyte monitoring. Results Fifty-eight pregnancies in 52 women were reported in GS, and 55 pregnancies in 27 women were reported in BS. Adverse events and symptoms, including intrauterine growth restriction, oligohydramnios, preterm birth, fatigue, weakness, and paraesthesia, were commonly reported. The mainstay of therapy remains oral and intravenous electrolyte replacement coupled with frequent monitoring. Conclusions The management of GS and BS in pregnancy presents a challenge and has the potential for significant maternal and neonatal morbidity.