Pregnancy after renal transplantation: five cases

Objective: With the increasing rates of successful renal transplantations, the desire to get pregnant has come into prominence in fertile women. After renal transplantation, renal and endocrine functions return to normal values rapidly and ovulatory menstrual cycles begin; patients planning pregnancy can have a healthy pregnancy and live birth. In this study, we aimed to discuss pregnancies with renal transplantation followed up in our clinic. Methods: Gestational follow-ups and perinatal outcomes of 5 patients who underwent renal transplantation due to end-stage renal failure and then got pregnant and delivered within the last two years at Dr. Lütfi K›rdar Kartal Training and Research Hospital were evaluated. Results: Of the cases, mean age was 28.4±3.04 (range: 25 to 32) years, gravida was 2 (range 1 to 3), parity was 0 (range: 0 to 1), abortion was 0 (range: 0 to 2), mean week of delivery was 36.2±1.09 (range: 35 to 38) weeks, and mean birth weight was 2470±519.13 (range: 2000 to 3280) g. Of the patients, protein amount in 24-h urine was 3174.6±5458.41 (range: 94 to 12,783) mg, and the period between renal transplantation procedure and pregnancy was 4.7±1.92 (range: 2.5 to 7) years. Four of the cases were delivered due to obstetric reasons and one of them was delivered by C-section with the advice of nephrology department. No congenital anomaly was found in any of the baby of the cases. Conclusion: There are many risks for patients with renal transplantation in terms of maternal and fetal aspects. Resulting pregnancy successfully depends on keeping the doses of immunosuppressive drugs at a level both protecting graft functions and not harming fetus, and the follow-up and treatment of gestational complications. Therefore, a multidisciplinary approach consisting of nephrology, obstetrics and neonatology specialists should be recommended for the follow-up of patients.