Can you get pregnant?What should I do if I am still taking medicine?

Author Zhou Xun Chief Physician

Many people think that if you get kidney disease, you cannot get pregnant and have children, especially female friends. If you are pregnant, you will increase the disease of the kidney disease and turn into uremia.Pregnancy and having children are very concerned whether men or women’s kidney disease.So, can you get pregnant?What should I do if I am still taking medicine?

The problem of pregnancy and pregnancy that I talked about today mainly refers to "primary chronic kidney disease", which mainly includes hidden nephritis, IgA nephropathy, chronic nephritis, nephropathy syndrome, membrane hyperplasia, mild lesion, membrane nephropathy, membrane, membrane, membraneProliferate nephritis and segmented glomerular hardening, but do not include lupus nephritis, primary drying syndrome, and diabetic nephropathy.

It is generally believed that if the patient’s blood pressure is normal and the renal function is normal, that is, or the renal function has mild damage, the patient’s pregnancy process will be relatively smooth, and the chance of success is more than 90%.After the end of pregnancy, the renal function will also be stable.However, there are already hypertension, or the unsatisfactory control of hypertension, or a moderate degree of renal insufficiency. The chance of complications in patients’ pregnancy and the chances of renal dysfunction after pregnancy will greatly increase.At the same time, the fetal prognosis is poor.The total amount of urinary protein in 24 hours is greater than 2.0 grams. It may indicate a decline in renal function during pregnancy.At the same time, the amount of protein urine during pregnancy is directly related to the development of the fetus.

In addition, the pathological type of chronic kidney disease not only reflects the severity of the disease, but also is smoothly related to whether the process of pregnancy is smooth.Among the various pathological types of primary glomerular diseases, it is generally believed that the mild pathological changes and the pathological types with good treatment reactions are better after pregnancy. On the contraryThe pathological type of pregnancy is poor.The prognosis of small lesions, mild membrane hyperplasia glomerular nephritis, and membrane nephropathy is better, while the prognosis of segmented glomerular sclerosis and membrane hyperplasia glomerular nephritis is poor.

IGA nephropathy is a very common glomerular disease. Now it seems (different from the previous views) IgA nephropathy has little effect on pregnancy and after pregnancy.But patients with IgA nephropathy 4 and above should not be pregnant.

In summary, the conditions for whether patients with primary chronic kidney disease can pregnancy should be as follows:

1. Normal blood pressure;

2. The kidney function is normal or basically normal;

3. There is no large amount of proteinuria (usually the total amount of urine protein is less than 2.0 grams);

4. The type of nephrotic pathology is mild, and there is no obvious inter -tubular quality and vascular disease.

If you do not do kidney puncture, you can mainly meet the above three.Of course, it is best to be more assured of the pathological type of renal puncture. If you are pregnant after you have a clear pathology, you can be more assured.

Even if the above conditions are met, the monitoring during pregnancy should be strengthened after pregnancy. In the early pregnancy, the urine protein quantitative, renal function, blood pressure and fetal development should be checked every two weeks.Once the renal function decreases sharply, the blood pressure is difficult to control, and a large amount of proteinuria does not decrease, it does not increase but increases. It is necessary to make an interruption, weigh the advantages and disadvantages, and terminate pregnancy in a timely manner.If the condition can still be controlled, you can wait until the fetus is mature and end the pregnancy as soon as possible.

Medicine always has unexpected situations.Pregnancy is not a relaxed thing for normal women. When science is underdeveloped, many women died because of pregnancy.Pregnancy is a big challenge for the kidneys. It is necessary to safely pass the special period of pregnancy. It requires obstetrics and nephrology, and patients work together.

If you are preparing to get pregnant, you are still taking medicine, and the following medicines cannot be taken.The medication needs to be adjusted according to the condition.

1. All Pribli and Satan, such as chlestan (Kosia), Benan Pribei (Lotinxin), Pushadan (Daiwen), etc., you need to discontinue for at least three months in advance for pregnancySuch drugs (the word "Pribi" or "Satan" in the name of the pharmaceutical chemistry).

2. Some immunosuppressants, such as cyclumamide, thundervama,? Maccinophen (Xiaoxin), Laoflimit, is risk of teratogenic and is forbidden drugs for pregnancy.

If you are preparing to get pregnant, you are still taking medicine, and the following medicines can be continued.

1. Poronis pine tablets and metrophic nylon (except for diusonus and Beamison): can reduce dosage and maintain treatment with small doses, but mothers and fetuses must be tightly monitored during the medication.

2. Other immunosuppressants: Circus A, Hiscormus, Repeamycin, and azozimine are considered to be relatively safe. If you still fail to be used during pregnancy, you need to monitor the concentration of blood medicine.

3. Some antihypertensive drugs can be taken: such as methylbaba, Labelol, and nitopenzine (but a nitopenphenylplastic interpretation tablets for pregnant women within 20 weeks of pregnancy).

If it is a male pregnancy, it is mainly used by cyclospamide.As for other kidney medicines, such as Prubi and Salin drugs, various hormones, cyclosporine A, hekmomis,?Use it, don’t worry too much.

The article comes from the WeChat public account of "kidney is the first"

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