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Pregnancy after renal transplantation – a five‐yr single‐center experience
Author(s) -
Oliveira Leandro G.,
Sass Nelson,
Sato Jussara L.,
Ozaki Kikumi S.,
Medina Pestana Jose O.
Publication year - 2006
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2006.00627.x
Subject(s) - medicine , pregnancy , transplantation , preeclampsia , premature rupture of membranes , gestational age , urinary system , obstetrics , tacrolimus , surgery , genetics , biology
Background: There has been an increase in the number of pregnancies in renal transplant recipients. Our aim was to report our experience with a significant casuistic. Methods: Fifty‐two pregnancies in 52 patients (January 2001 to December 2005), with two patients having a multiple pregnancy, were evaluated and patients were characterized and evaluated as clinical and obstetrical and perinatal outcomes. Results: Mean patient age was 26.5 yr (range 17–38) with live donors in 34 (65.4%) and cadaver donors in 18 (34.6%). The mean transplantation‐pregnancy interval was 3.1 yr. Calcineurin inhibitors (cyclosporine or tacrolimus) comprised the immunosuppressive therapy in 49 pregnancies (94.2%). Pregnancy complications were chronic hypertension in 33 patients (63.5%), anemia in 31 (59.6%), urinary tract infection in 22 (42.3%) and diabetes in four (7.7%). Nine patients (17.3%) received blood transfusion. Preeclampsia was diagnosed in 16 cases (30.7%) and renal dysfunction in 23 (44.2%) with preeclampsia assumed to be the main cause. One patient (1.9%) had graft loss, as a result of hemorrhagic shock after preterm delivery at home. Premature rupture of membranes occurred in four cases (7.7%), and preterm delivery in 20 (38.4%). Sixteen (29.6%) newborn were small for gestational age. One case of neonatal death was registered as a result of excessive prematurity. Cesarean section was performed in 32 patients (61.5%), the main indications being related to hypertension syndromes and fetal distress. Conclusions: This group of patients is characterized by a wide range of antenatal and perinatal problems and must be managed in specialized tertiary units to achieve the very best results.