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Clinical Review Interactive case report

A 35 year old woman with diabetic nephropathy who wants a baby: case progression

BMJ 2004; 329 doi: (Published 23 September 2004) Cite this as: BMJ 2004;329:729
  1. Giorgina Barbara Piccoli, medical researcher (,
  2. Elisabetta Mezza, nephrologist1,
  3. Giorgio Grassi, diabetologist2,
  4. Manuel Burdese, nephrologist1,
  5. Tullia Todros, associate professor3
  1. 1 Chair of Nephrology, Department of Internal Medicine, University of Turin, Corso Dogliotti, 14-10126 Turin, Italy
  2. 2 Diabetic Care Unit, Department of Internal Medicine, University of Turin
  3. 3 Department of Obstetrics and Gynaecology, University of Turin
  1. Correspondence to: G B Piccoli

    Last week (18 September, p 674), we discussed the case of Maria Tomasa who had requested assisted fertilisation despite being advised against pregnancy because of her nephropathy. We discussed her situation within our teams. The opinions were conflicting, but no one had direct experience of a similar case. However, we shared a common view on a patient's right to pursue her pregnancy and on pregnancy being a major determinant of a person's quality of life. Furthermore, we were aware that Tommy had chosen to be under our care because we were sympathetic towards a pregnancy. We therefore did a systematic search to retrieve relevant data.

    A search on Medline and Embase in December 2000 (updated in September …

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