- Fetal Upturned Nose
- IgA Nephropathy in Pregnancy
- Umbilical vein varix
- Timing of Cranial Markers in Open NTD
- Real world experience Open Neural tube defect and Brain Signs
- Real world experience First Trimester Megacystis – Management
- Real world experience Fetal Megacystis
- Abnormal facial profile
- Azygous Vein & ARSA
- Blakes Pouch Cyst
- Absent nasal bone (ANB)
- Choroid plexus cysts
- Chronic placental abruption
- Fetal Alcohol Syndrome
- Placenta-First Risk Stratification
- AVSD
- Blakes Pouch Cyst
- Confined Placental Mosaicism
- Echogenic Bowel
- Fetal Anemia
- Fetal Club Foot
- Fetal Mild Micromelia
- Hypochondroplasia – Mild Micromelia
- Hypoplastic Nasal Bone
- IgM IgG IgG Avidity
- Increased Nuchal Translucency
- Isotretinoin in Pregnancy
- Partial agenesis of corpus callosum
- PGT A
- PGT-A Mosaicism to CPM
- Placenta First - CPM
- Radiation exposure during pregnancy
- Real world Chorionic bump experience
- Real world Fetal Isotretinoin exposure
- Real world Increased Nuchal Translucency & Genetic RISK
- Real world Renal Pyelectasis
- Real world Transient NT & Cystic Hygroma
- Real world Transient NT
- Renal Pyelectasis or Extra Renal Pelvis
- Right And Double Aortic Arch
- Short Femur Length Foot FL ratio
- Y Microdeletion
- CCAM CPAM
- Coffin–Siris syndrome
- Congenital CMV Infection
- Increased NT and Localized CHAOS
- Indomethacin and Reduction for AFI
- Atrioventricular septal defect (AVSD)
- Choledochal cyst & Cystic biliary atresia
- Duodenal Atresia
- Fetal atrial bigeminy
- Fetal Dilated stomach
- Mutation Types in DMD
- Risk of rubella in nonimmune pregnant woman
- Salt-losing nephropathy
- Syndromic Cystic biliary atresia
- TGA DORV TOF CCTGA
- Unilateral echogenic kidney with polyhydramnios
- Unilateral renal agenesis, Ectopic, Cross fused kidney
IgA nephropathy in Pregnancy: Maternal and Fetal Implications
IgA nephropathy is the most common primary glomerular disease worldwide. Results from deposition of IgA-containing immune complexes in the kidney mesangium, causing hematuria, proteinuria, hypertension, and, in some patients, progressive chronic kidney disease.
Most Low-Risk Women
For women with:
• normal serum creatinine,
• minimal proteinuria,
• normal or well-controlled blood pressure,
the most common course is:
1. Stable kidney function
2. Mild transient increase in proteinuria
3. Successful delivery of a healthy baby
4. Return to baseline renal status postpartum
Course May Be Less Favorable
Complications are more likely if the mother has:
• significant proteinuria (>1 g/day),
• chronic hypertension,
• reduced kidney function,
• or previous progressive kidney disease.
These women have higher risks of:
• Preeclampsia,
• Fetal growth restriction,
• preterm delivery,
• and long-term decline in renal function.
Women with mild, stable IgA nephropathy and preserved kidney function have successful pregnancies.
The main determinants of fetal outcome are the degree of:
• renal impairment, proteinuria, hypertension, and superimposed preeclampsia.
Pregnancy increases:
• plasma volume, renal blood flow, glomerular filtration rate, and physiologic protein excretion.
In women with IgA nephropathy, this can:
• unmask previously mild disease, worsen proteinuria, trigger hypertension, and increase the risk of kidney function decline in those with advanced disease.
Women with:
• normal serum creatinine, low proteinuria, and controlled blood pressure often tolerate pregnancy well.
Major Maternal Risks
A. Worsening Proteinuria
Protein excretion often rises during pregnancy and may reflect physiologic changes, indicate disease activity, or signal developing preeclampsia.
B. Hypertension
Chronic hypertension is common and substantially increases obstetric risk.
C. Preeclampsia
Women with underlying kidney disease have a markedly higher risk of Preeclampsia.
D. Acute Kidney Injury
Uncommon in mild disease but possible in severe renal impairment or preeclampsia.
E. Long-term Kidney Decline
Pregnancy usually does not accelerate progression when renal function is normal, but risk rises with advanced chronic kidney disease.
Effects on the Fetus
The fetus is not directly affected by maternal IgA antibodies crossing the placenta.
The main fetal risks are secondary to placental dysfunction caused by maternal kidney disease and hypertension.
Principal Fetal Risks
• Fetal growth restriction; Preterm birth; Low birth weight; Preeclampsia leading to medically indicated early delivery; Rarely stillbirth in severe maternal disease
The strongest prognostic factors are:
Best Prognosis
• Serum creatinine in the normal range
• eGFR > 90 mL/min/1.73 m²
• Proteinuria < 500 mg/day (or low urine protein-creatinine ratio)
• Normal blood pressure
• No prior progressive kidney decline
Intermediate Risk
• Proteinuria 0.5–1 g/day
• Mild hypertension
High Risk
• Serum creatinine > 1.2–1.4 mg/dL (risk increases progressively)
• Proteinuria > 1 g/day, especially > 3 g/day
• Uncontrolled hypertension
• CKD stage 3 or higher
• Prior severe preeclampsia
Practical Summary
The “usual” course of IgA nephropathy in pregnancy is:
• Mild increase in proteinuria
• Stable creatinine
• Careful monitoring for hypertension and Preeclampsia
• Delivery at or near term in many cases
• Return to baseline kidney status after birth