Author: Leo
Key words: pregnancy | kidney |
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| From google images |
Women in pregnancy, in order to meet the needs of the fetus, almost all of the organ system will occur more or less changes, the kidneys are no exception, some changes may be troubled pregnant mother, you know how much? Do you know which changes can be fearless and which changes are necessary to get attention
What changes will the kidneys occur during pregnancy?
In general, the kidneys will change from shape and function. The first shape becomes larger and the second function is enhanced.
First, the kidneys will become larger, during pregnancy, the two kidneys increase the diameter of the upper and lower 1-1.5cm. If pregnant women do ultrasound, kidney than before pregnancy, do not be too surprised, not kidney swollen or fat. This is normal renal normal physiological changes during pregnancy, mainly renal vascular and interstitial volume increases, but the number of nephrons did not increase.
Kidney function is powerful how is it?
Mainly during pregnancy will occur a wide range of vasodilatation, increased arterial compliance and systemic vascular resistance decreased, these systemic hemodynamic changes, will make more blood flow to the kidney, kidney function has become strong, The glomerular filtration rate (GFR) is increased. The increase in GFR was observed within 1 month after conception, reaching the peak in the middle of pregnancy (as shown below).
We need to pay attention to is: If the examination of renal function during pregnancy, serum creatinine concentration will be reduced, normal pregnancy serum creatinine fluctuations in the 35-70μmol / L. If pregnant women serum creatinine more than 88μmol / L, be careful of the kidney there is a problem.
What are the unexpected problems during pregnancy?
More common is frequent urination, nocturia increased, dysuria, urgency and stress urinary incontinence and other issues. We come to explore one by one:
Urinary frequency (urination more than 7 times a day) and nocturia increased (nocturnal urination ≥ 2 times) in the most common during pregnancy, probably will affect 80% -95% of women. If the examination is not a urinary tract infection, do not affect life and sleep, should not be a problem, be considered a physiological change during pregnancy, usually do not need special treatment.
Urinary urgency and urinary incontinence may be due to increased uterine compression of the bladder, progesterone and urethral transverse sphincter neuromuscular function caused by changes. If the urinary incontinence is more serious, it is recommended timely treatment of obstetricians, try to desmopressin and other drugs and pelvic floor muscle training and other adjuvant therapy.
In addition to the above physiological manifestations, we may face the following small problems and big problems:
Urinary tract infection: With the increase in pregnancy, the fetus's palace (uterus) also gradually become larger, this change will make bilateral ureter becomes narrow, distorted and displaced to the outside, think of all distressed. The result is caused by bilateral kidney and ureteral water, resulting in urinary obstruction, may provide a breeding ground for bacteria, prone to acute pyelonephritis. Urinary tract infection is typical of frequent urination, urgency, dysuria and other urinary tract irritation symptoms, and may be associated with cold, fever, low back pain and other performance, should be timely treatment of obstetrics or nephrology, if the infection is clear, may need antibiotics treatment.
General use of small toxicity, such as amoxicillin, nitrofurantoin or cephalosporin antibiotics, acute cystitis generally treated 3-7 days, acute pyelonephritis usually need intravenous antibiotic therapy, available semi-synthetic broad-spectrum penicillin or third-generation cephalosporins Fungal treatment, treatment for 2 weeks. Professional things can be left to the doctor to deal with, as the patient we can understand, do not mind the number of fear.
Low blood pressure: the front also mentioned, due to reduced systemic vascular resistance, blood pressure can be reduced by 20-25mmHg, some women in pregnancy before the blood pressure is relatively low, if the blood pressure during pregnancy is relatively low, if there is no obvious dizziness and chest tightness and other discomfort , Should not be the problem, do not be too nervous.
Hypertension: If pregnant women with blood pressure ≥ 130 / 80mmHg, or increased pre-pregnancy systolic blood pressure ≥ 30 mmHg, and diastolic blood pressure ≥ 15 mmHg, should be alert to the occurrence of pregnancy-induced hypertension. Blood pressure ≥ 160/100 mmHg should pay attention to the occurrence of preeclampsia. There is a problem in a timely manner, mild hypertension generally do not need drug treatment, left lying lying on the rest may be helpful to reduce blood pressure.
Blood pressure> 140/90 mmHg need antihypertensive therapy, drug preferred: methyl dopa, pull belrolol, nifedipine, magnesium sulfate and so on.
High blood sugar: pregnancy may occur during gestational diabetes, so the second trimester (24 weeks -28 weeks) when the blood glucose screening. Especially for overweight and have a family history of diabetes pregnant mother, to guard against the occurrence of gestational diabetes, blood glucose can be monitored early.
How to deal with the risk of kidney during pregnancy?
General population, pre-pregnancy should be a comprehensive physical examination or pregnancy test (including blood pressure, liver and kidney function, thyroid function, hematuria routine, hepatitis B five, heart ultrasound and other checks) to rule out the presence of special diseases and genetic diseases, Hypertension, diabetes, kidney disease, lupus, asthma, thyroid disease, epilepsy, hepatitis B and AIDS, autosomal dominant polycystic kidney disease and other genetic diseases. Some diseases must be considered better after the control of pregnancy, some diseases may not be suitable for the baby, some genetic diseases (such as polycystic kidney disease) may require medical intervention to produce a more healthy baby.
For young women with previous kidney disease, if you want to be pregnant to the baby, it is best to do kidney biopsy clear pathology of kidney disease and do a comprehensive renal function tests, for obvious proteinuria, uncontrolled high blood pressure and Renal insufficiency patients should not be pregnant.
Our experience is generally recommended in the kidney disease control smooth 1 - 2 years later, while normal renal function (serum creatinine ≥ 125umol / L, not pregnant), then consider pregnancy. After all, the burden of kidney during pregnancy will increase, pregnancy for the kidneys is an adventure, whether it is for pregnant mother, or the fetus is a huge test.
Pregnant women should be regularly designated to the hospital pregnancy test, if there urine protein, blood pressure, renal damage, obstetricians should promptly contact with the renal physician joint consultation, co-designated treatment program.
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