Gestational hypertension and preeclampsia associated with unilateral renal agenesis in women with uterine malformations

OBJECTIVE: To evaluate the possible connection between gestational hypertensive disorder and unilateral renal agenesis in women with congenital uterine anomalies. STUDY DESIGN: Thirty-three (16%) out of 206 women with uterine anomalies had unilateral renal agenesis. Nineteen of them had delivered and comprised the study group. The control group consisted of 44 women among the 206 with similar uterine malformations who had normal bilateral kidneys and matched in age and parity with the study group. Retrospective analysis considered the presence of gestational hypertension, proteinuria, preeclampsia, perinatal outcomes and manifestations of hypertension and renal disease during the follow-up period in both groups. The median follow-up was 166 months (range 24-372 months). RESULTS: Women with unicornuate uterus most frequently (25%) evinced unilateral renal agenesis. Eight (42%) out of 19 women with malformed uterus and unilateral renal agenesis had in at least one pregnancy gestational hypertension, preeclampsia or gestational proteinuria compared to 8 (18%) out of 44 women with two kidneys (relative risk, RR 2.33, 95% CI 1.02, 5.29). Seventeen (35%) out of all 49 pregnancies in the study group were complicated by gestational hypertensive disorder or proteinuria as against 10 (11%) out of 90 pregnancies in the control group (RR 3.12, 95% CI 1.55, 6.28). Perinatal outcomes were similar in both groups. During follow-up none had diagnosed proteinuria or chronic renal disease, but two out of 19 women (11%) with unilateral renal agenesis had commenced medication for chronic hypertension. CONCLUSION: Unilateral renal agenesis predisposes women with uterine anomalies to preeclampsia.