埼玉医科大学雑誌 第33巻 第2号 (2006年4月) 25-32頁 ◇論文(図表を含む全文)は，PDFファイルとなっています．
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Recent and Remote Prognosis of Toxemia
Pregnancy-induced toxemia is named as pregnancy-induced hypertension syndrome and its definition is based on hypertension but not in proteinuria and edema. Previously pregnancy-induced toxemia is composed of three symptoms of hypertension, proteinuria and edema. In the present study, two studies were carried out. The first study examined renal patho-histology in 30 proteinuric patients who had a past history of toxemia. Ten patients had IgA nephropathy, 10 did glomerulosclerosis and 10 did focal glomerulosclerosis. The factors, such as the age of pregnancy, the levels of blood pressure and the degree of proteinuria during pregnancy, were not significantly different among three groups. However, the levels of serum creatinine in patients with focal glomerulosclerosis were significantly lower than those with IgA nephropathy and /or with glomerulosclerosis. In addition, there was no significantly difference of the two factors between the latter two groups. These data suggest that patients who were previously defined as having pregnancy-induced toxemia were composed at least of three types of nephropathy. From this study, patients who had proteinuria during pregnancy should be carefully followed up and if proteinuria persisted more than a year renal biopsy for diagnosis of nephropathy should be considered. In the second study, 52 patients who were diagnosed as having pregnancy-induced hypertension were followed up for a year after delivery. In 9 patients, high blood pressure more than 140 mmHg systolic or 90 mmHg diastolic was maintained beyond one year. A comparison between the patients whose blood pressure became less than 140 and 90 mmHg within a year and those did not revealed a significant difference in systolic blood pressure at the presentation of pregnancy-induced hypertension syndrome although any other factors such as age, the levels of proteinuria and so on. did not show any significant differences between the two groups. From the second study, the levels of systolic blood pressure might be predictable index for development of hypertension after delivery in patients with pregnancy-induced hypertension syndrome. Combining these two studies, it is concluded that if proteinuria or high blood pressure persists more than one year after delivery more cautious follow-up would be preferable.