ABSTRACT Background: Pregnancy in women with glomerular disease (GD) is high risk and requires prepregnancy, risk stratification, close monitoring during pregnancy, and structured postpartum follow-up. Care practices, however, remain highly variable. This study describes real-world follow-up patterns. Methods: This retrospective study included females of reproductive age (18–49 years) with biopsy-proven GD. Electronic medical charts were used to retrieve clinical data. Outcomes included timing of follow-up initiation, involvement of Maternal–Fetal Medicine, obstetric nephrology, and general nephrology, postpartum follow-up at 6 weeks or 3 months, and frequency and adequacy of laboratory monitoring, particularly renal function and urine studies. Results: Between 2010 and 2022, 33 women with GD and pregnancy were identified (50 pregnancies). After exclusions, 43 pregnancies were analyzed. Follow-up showed substantial variability. Maternal–Fetal Medicine was involved in 51% of pregnancies, obstetric nephrology in 23%, and general nephrology in 23%, leaving 53% without any nephrology follow-up. Only 21% were co-managed by Maternal–Fetal Medicine and obstetric nephrology. Postpartum nephrology follow-up occurred in 19% at 6 weeks and 16% at 3 months. Laboratory monitoring was often inadequate: Only 51% had labs checked more than three times, the minimum expected panel was complete in 35%, and proteinuria was not quantified in 53% of pregnancies. Conclusions: Significant inconsistencies and gaps exist in the monitoring and multidisciplinary management of pregnant patients with GD. Our study proposes a more standardized care model.
Ghada Ankawi (Fri,) studied this question.
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