TITLE:
Nephrotic Syndrome Management in Pregnancy: A Diagnostic and Therapeutic Challenge in a Resource-Limited Setting—A Case Report
AUTHORS:
Véronique Sophie Mboua Batoum, Esther Juliette Meka Ngo Um, Christiane Nsahlaï, Pascale Mpono, Ngo Dingom Madie, Cho Joseline Nyuykighan, Serge Nyada, Tompeen Isidore, Francois Kaze, Elie Nkwanong
KEYWORDS:
Nephrotic Syndrome, Pregnancy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.9,
September
4,
2025
ABSTRACT: Nephrotic syndrome is a rare condition in pregnancy. This case report highlights the challenging management of nephrotic syndrome in a pregnant woman in a resource-limited hospital. Case presentation: We report the case of a 35-year-old grand multiparous woman, at 19 weeks + 3 days of gestation, treated for pulmonary tuberculosis in 2018, who presented in 2025 with a 3-week history of lower limb swelling that progressed progressively to the abdomen, also associated with early morning face and neck swelling, fatigue, and occasional breathing difficulties. Urinalysis showed 2+ proteinuria. Chest X-ray revealed atelectasis of the left upper lobe. Management included furosemide for 1 week. Further laboratory investigations at 20 weeks of gestation revealed: urine dipstick of 3+ proteinuria, severe hypoalbuminemia, elevated serum urea and creatinine, hyperlipidemia, and stage 2 nephropathy consistent with nephrotic syndrome. Obstetrical ultrasound showed an intrauterine singleton pregnancy, homogenous hepatomegaly, and ascites of moderate quantity. Treatment instituted involved mainly human albumin infusions, fluid restriction, and anticoagulants. Hospitalization stay was marked by improvement of symptoms, and the patient was discharged on day 15 on cardio aspirin, iron, and potassium iodide tablets. The patient, due to reported financial constraints, did not keep her appointment one week later. The patient reportedly developed respiratory difficulties at about 28 weeks gestation for which she was hospitalized in the initial health facility; cesarean section was performed in the course of hospitalization, complicated by both fetal and maternal demise within a 48-hour interval. Conclusion: In resource-limited contexts, nephrotic syndrome in pregnancy is a medical challenge with high mortality.